Active NPI
Alan N Rucket, M.D.
- Specialist
- Sandy Springs, GA
National Provider Identifier
1821090705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 15980
- Practice address
- 1005 Ivy Falls Dr
Sandy Springs, GA 30328-3658 - Phone
- (404) 255-1005
- Fax
- (404) 255-1184
- NPI assigned
- Aug 11, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 15980 | GA | Primary |
Addresses
Primary practice location
1005 Ivy Falls Dr
Sandy Springs, GA 30328-3658
Mailing address
1005 Ivy Falls Dr
Sandy Springs, GA 30328-3658
Phone (404) 255-1005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00442065A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160301001022 | GA | Order and Referring Only - Obstetrics/Gynecology | 1850696758 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15980 | GA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1821090705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 IVY FALLS DR",
"city": "SANDY SPRINGS",
"state": "GA",
"postal_code": "303283658",
"telephone_number": "404-255-1005",
"fax_number": "404-255-1184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 IVY FALLS DR",
"city": "SANDY SPRINGS",
"state": "GA",
"postal_code": "303283658",
"telephone_number": "404-255-1005",
"fax_number": "404-255-1184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUCKET",
"first_name": "ALAN",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-11",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "15980",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00442065A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sandy Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.