Individual provider Active NPI

James S Ruckel, DC

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1871582783
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001766 Issued in IN
Practice address
7313 W Jefferson Blvd
Fort Wayne, IN 46804-6237
Phone
(260) 436-5200
Fax
(260) 436-1103
NPI assigned
Oct 14, 2005
Last updated
Mar 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001766 IN Primary

Addresses

Primary practice location

7313 W Jefferson Blvd
Fort Wayne, IN 46804-6237

Mailing address

7313 W Jefferson Blvd
Fort Wayne, IN 46804-6237
Phone (260) 436-5200

Other identifiers 3

IdentifierTypeStateIssuer
000000531878OtherINANTHEMBC/BS
350049797OtherINMEDICARE RAILROAD
200156050AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071107000632 IN Practitioner - Chiropractic 7315034360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7313 W Jefferson Blvd
Fort Wayne, IN 46804-6237
Phone (260) 436-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ruckel, Inc. Chiropractor CurrentSince Oct 15, 2007 Accepting new patients

Locations

7313 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-5200

Organizations & group practices 1

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1871582783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7313 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046237",
            "telephone_number": "260-436-5200",
            "fax_number": "260-436-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7313 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046237",
            "telephone_number": "260-436-5200",
            "fax_number": "260-436-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKEL",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEMBC/BS",
            "identifier": "000000531878",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "350049797",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200156050A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.