Individual provider Active NPI

Deborah Ruskell, MSTCCCSLP

  • Speech-Language Pathologist
  • Apple Valley, MN
National Provider Identifier
1679616734
Registry record updated Nov 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7010 Issued in MN
Practice address
14635 Pennock Ave
Suite 300
Apple Valley, MN 55124-6430
Phone
(952) 997-2823
Fax
(952) 997-6931
NPI assigned
Feb 15, 2007
Last updated
Nov 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7010 MN Primary

Addresses

Primary practice location

14635 Pennock Ave
Suite 300
Apple Valley, MN 55124-6430

Mailing address

4058 Deerwood TRL
Eagan, MN 55122-1889
Phone (651) 994-9644

Other identifiers 4

IdentifierTypeStateIssuer
4600209OtherMNMEDICA
473920500MedicaidMN
964S9RUOtherMNBCBS
HP32765OtherMNHEALTH PARTNERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160115001273 MN Practitioner - Qualified Speech Language Pathologist 7517260011 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Therapy Ctr, Inc Speech-Language Pathologist PastSince Dec 15, 2015 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1679616734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4058 DEERWOOD TRL",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221889",
            "telephone_number": "651-994-9644",
            "fax_number": "651-994-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14635 PENNOCK AVE",
            "address_2": "SUITE 300",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246430",
            "telephone_number": "952-997-2823",
            "fax_number": "952-997-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSKELL",
        "first_name": "DEBORAH",
        "credential": "MSTCCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "7010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4600209",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "473920500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "964S9RU",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP32765",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.