Vashtina G Ellison-Ruddock, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN1002387 Issued in DC

Practice address

2226 Wisconsin Ave, NW
Washington, DC 20007

Phone

(202) 994-8671

NPI assigned

Nov 21, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Ruddell Medical Services

  • Primary Care Clinic/Center
  • Takoma Park, MD
  • NPI 1184448623

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1699042523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 OTIS PLACE, NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20010",
            "telephone_number": "202-549-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 WISCONSIN AVE, NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20007",
            "telephone_number": "202-994-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON-RUDDOCK",
        "first_name": "VASHTINA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1002387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP-ADVANCED PRACTICE REGISTERED NURSE",
            "identifier": "RN1002387",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP-ADVANCED PRACTICE REGISTERED NURSE",
            "identifier": "R159793",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ellis
• Sydney Ellis
• Tamika Laquisha Ellis, AH CPR/FIRSTAID CERT
• Travis Ellis
• Willie Lee Ellis I
• Christopher Winston Ellison, PHARM.D.
• Lamont Tairi Ellison
• Merri Doretha Ellison
• Rachelle Ellison
• Rashad Ellison

• Family Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Family Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.