Active NPI
Jim Everett Ruckman, JIM RUCKMAN D.M.D.
- Endodontics
- Eugene, OR
National Provider Identifier
1679738850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- D9767
- Practice address
- 750 Goodpasture Island Rd
Eugene, OR 97401-1751 - Phone
- (541) 484-0470
- NPI assigned
- Jul 27, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | D9767 | OR | Primary |
Addresses
Primary practice location
750 Goodpasture Island Rd
Eugene, OR 97401-1751
Mailing address
1595 Regency Dr
Eugene, OR 97401-7078
Phone (541) 232-7256
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D9767 | OR | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley River Endodontics, LLC | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Eugene, OR
- NPI 1396283016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426464000000",
"number": "1679738850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1595 REGENCY DR",
"city": "EUGENE",
"state": "OR",
"postal_code": "974017078",
"telephone_number": "541-232-7256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 GOODPASTURE ISLAND RD",
"city": "EUGENE",
"state": "OR",
"postal_code": "974011751",
"telephone_number": "541-484-0470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUCKMAN",
"first_name": "JIM",
"middle_name": "EVERETT",
"name_prefix": "Dr.",
"credential": "JIM RUCKMAN D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-27",
"last_updated": "2015-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "OR",
"license": "D9767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.