Elleston Craig Rucker LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

6766 Issued in NV

Legal business name

ELLESTON CRAIG RUCKER LLC

Practice address

811 S Decatur Blvd
Las Vegas, NV 89107-3933

Phone

(702) 439-5283

NPI assigned

Apr 16, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Elleston Craig Rucker, MD

Title

Owner

Phone

(702) 439-5283

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523836800000",
    "number": "1669969754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 S DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891073933",
            "telephone_number": "702-439-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891073933",
            "telephone_number": "702-439-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLESTON CRAIG RUCKER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "ELLESTON",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-439-5283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "6766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679601470",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Melissa Elkins
• Daniel R Elkins Jr.
• John W Elkins
• Kiley Ellefson
• John Allan Ellerton, MD, CM
• Ashlen Ellingsen
• Amanda Ellingsworth
• Elliot Wade MD Inc
• Chewannia R Elliot
• Jolene Elliot

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.