Individual provider Active NPI

Raquel Batrice Ruggiero, DNP PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Logan, UT
National Provider Identifier
1801413000
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13194783-4405 Issued in UT
Practice address
184 N 100 E Ste C
Logan, UT 84321-5277
Phone
(435) 395-5993
Fax
(385) 367-2294
NPI assigned
Jul 3, 2020
Last updated
Sep 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13194783-4405 UT Primary

Addresses

Primary practice location

184 N 100 E Ste C
Logan, UT 84321-5277

Mailing address

184 N 100 E Ste C
Logan, UT 84321-5277
Phone (435) 395-5993

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230727000770 UT Practitioner - Nurse Practitioner 7911368782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Loma Linda University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martin Medical Group LLCGroup PAC ID 4284099177, 3 clinicians

Practice addresses (Care Compare)

115 Golf Course Rd
Suite E
Logan, UT 84321-5934
Phone (435) 799-5035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95018355CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stillpoint Wellness LLC Psychiatric/Mental Health Current Accepting new patients
Martin Medical Group LLC Psychiatric/Mental Health CurrentSince Jun 16, 2023 Accepting new patients
Palm Desert Psychiatry Inc PastSince Oct 1, 2021 Accepting new patients
Central Coast Behavioral Health, Inc. Psychiatric/Mental Health PastSince Sep 5, 2023 Accepting new patients

Locations

115 Golf Course Rd
Ste E
Logan, UT 84321
Phone (435) 799-5035

184 N 100 E
Ste C
Logan, UT 84321
Phone (435) 395-5993

701 S Main St
Ste 100
Logan, UT 84321
Phone (410) 525-5005

Organizations & group practices 4

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": "1593734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1801413000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 N 100 E STE C",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843215277",
            "telephone_number": "435-395-5993",
            "fax_number": "385-367-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 N 100 E STE C",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843215277",
            "telephone_number": "435-395-5993",
            "fax_number": "385-367-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "RAQUEL",
        "middle_name": "BATRICE",
        "credential": "DNP PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-03",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "13194783-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.