NPIMap

Individual provider Active NPI

Katheryne Renee Ruck, DO

  • Family Medicine Physician
  • Mason, OH
National Provider Identifier
1538621263
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.014901 Issued in OH
Practice address
5075 Parkway Dr Ste 101
Mason, OH 45040-9555
Phone
(513) 584-6898
Fax
(513) 584-6897
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Family Medicine Physician 207Q00000X 34.014901 OH Primary

Addresses

Primary practice location

5075 Parkway Dr Ste 101
Mason, OH 45040-9555

Mailing address

5075 Parkway Dr Ste 101
Mason, OH 45040-9555
Phone (513) 584-6898

Other practice location 1

730 W Market St
Lima, OH 45801-4602
Phone (419) 227-3361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220629001966 OH Practitioner - Family Practice 8123448479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Cincinnati LLCGroup PAC ID 6709790892, 191 clinicians

Practice addresses (Care Compare)

5075 Pkwy Dr
Suite 101
Mason, OH 45040-9555
Phone (513) 686-5392

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati LLC CurrentSince Jul 17, 2022 Accepting new patients
Mercy Health Physicians Cincinnati, LLC Family Medicine CurrentSince Jul 17, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

8000 5 Mile Rd
Ste 100
Cincinnati, OH 45230
Phone (513) 233-2300

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

5075 Parkway Dr
Ste 101
Mason, OH 45040
Phone (513) 584-6898

Interoperability endpoints

  • Direct secure messaging: kruck642987@direct.bsmhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1538621263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5075 PARKWAY DR STE 101",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450409555",
            "telephone_number": "513-584-6898",
            "fax_number": "513-584-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 PARKWAY DR STE 101",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450409555",
            "telephone_number": "513-584-6898",
            "fax_number": "513-584-6897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 W Market St",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458014602",
            "country_code": "US",
            "telephone_number": "419-227-3361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCK",
        "first_name": "KATHERYNE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.014901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.