Individual provider Active NPI

Diana Rucker, M.D.

  • Specialist
  • Brookline, MA
National Provider Identifier
1689983694
Registry record updated Sep 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
17 Gardner Rd
Brookline, MA 02445-4512
Phone
(617) 669-7722
NPI assigned
Sep 26, 2010
Last updated
Sep 26, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

17 Gardner Rd
Brookline, MA 02445-4512

Mailing address

17 Gardner Rd
Brookline, MA 02445-4512
Phone (617) 669-7722

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1285459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285459200000",
    "number": "1689983694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 GARDNER RD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024454512",
            "telephone_number": "617-669-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 GARDNER RD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024454512",
            "telephone_number": "617-669-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-26",
        "last_updated": "2010-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2010; 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.