Nicole Ruopp

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2021032539 Issued in MO

Practice address

2432 E Main St
Jackson, MO 63755-2487

Phone

(573) 755-2305

NPI assigned

Apr 2, 2020

Last updated

Mar 19, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  Medicare reassignment NPD
• Southeast Missouri Hospital Physicians, LLC

  dba Mercy Clinic Southeast

  • Family Medicine Physician
  • Cape Girardeau, MO
  • NPI 1558311522
  Medicare reassignment NPD
• Southeast Hospital

  dba Mercy Pharmacy Broadway

  • Community/Retail Pharmacy
  • Cape Girardeau, MO
  • NPI 1336150846
  NPD (past)

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1750910873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 SANDISTAN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631465584",
            "telephone_number": "763-464-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2432 E MAIN ST",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552487",
            "telephone_number": "573-755-2305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2294 164th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Andover",
            "state": "MN",
            "postal_code": "553042156",
            "country_code": "US",
            "telephone_number": "763-464-7344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUOPP",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021032539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rock Care in Home Services, LLC
• Georgia Carmalea Rodgers
• Michelle R Rooker, L.C.S.W.
• Abigail Roth, PTA
• Amy Rowland
• Michaela D Rush, LBA, BCBA
• Saint Francis Medical Center (Saint Francis Clinic Jackson)
• Saint Francis Medical Center (Saint Francis Clinic Jackson)
• Saint Francis Medical Center (Saint Francis Clinic Jackson Wellness Center)
• Saint Francis Medical Center (Saint Francis Clinic Jackson Wellness Center)

• Physician Assistant in Jackson, MO
• Providers in Jackson, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.