Katrell Rucker

Primary specialty

Secured Medical Transport (VAN)Taxonomy code 343800000X

Practice address

5 Cedar Run LN Apt 7
Lake St Louis, MO 63367-2707

Phone

(636) 466-7745

NPI assigned

Apr 20, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1588308142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CEDAR RUN LN APT 7",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CEDAR RUN LN APT 7",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672707",
            "telephone_number": "636-466-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "KATRELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott K Roos, MD
• Shayla S Rose, M.D.
• Avon Lynn Rousan, LPC
• Kristen L. Rowe, M.D.
• Kelly Lynn Rubel, PT
• Christine Louise Rufkahr, PT
• S and M Baig MD PC
• Jayadev Sajja, MD
• Emily L Sammons, MD
• Sharon Leslie Samson, DC

• Secured Medical Transport (VAN) in Lake St Louis, MO
• Providers in Lake St Louis, MO by specialty
• Secured Medical Transport (VAN) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.