Elleston Craig Rucker, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

6766 Issued in NV

Practice address

811 S Decatur Blvd
Las Vegas, NV 89107-3933

Phone

(702) 439-5283

NPI assigned

Mar 1, 2007

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

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pasteur Medical Consultants

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1750815304

  NV

  Medicare reassignment NPD
• Restoration and Recovery, LLC

  • Mental Health Counselor
  • Las Vegas, NV
  • NPI 1467847657

  Internal Medicine, NV

  Medicare reassignment NPD
• Restoration and Recovery, LLC

  • Substance Abuse Rehabilitation Facility
  • Las Vegas, NV
  • NPI 1215757836
  NPD
• Nevada Integrated Behavioral Services Inc.

  • Adult Mental Health Clinic/Center
  • Las Vegas, NV
  • NPI 1457742975
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523750400000",
    "number": "1679601470",
    "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": {
        "last_name": "RUCKER",
        "first_name": "ELLESTON",
        "middle_name": "CRAIG",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2018-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "6766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruckdeschel Manno, LTD. Dba
• Archie Rucker
• Colby R Rucker
• Daniel J Rucker
• Ehraeda Faith-Noelle Rucker, MA, QMHA
• Henry McKinley Rucker
• Joshua Rucker
• Kameya Rucker
• Kristina Rucker, CPC
• Lesia Ann Rucker

• All providers in Las Vegas, NV
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.