Individual provider Active NPI

Rose Marie Rucker, RBT

  • Behavior Technician
  • Houston, TX
National Provider Identifier
1891261988
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
1743434 Issued in TX
Practice address
16319 Eaglewood Shadow Dr
Houston, TX 77083-6292
Phone
(281) 313-3203
NPI assigned
Oct 16, 2018
Reactivated
Oct 24, 2018
Last updated
Oct 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 1743434 TX Primary

Addresses

Primary practice location

16319 Eaglewood Shadow Dr
Houston, TX 77083-6292

Mailing address

16319 Eaglewood Shadow Dr
Houston, TX 77083-6292
Phone (281) 313-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1743434TXMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1891261988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16319 EAGLEWOOD SHADOW DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770836292",
            "telephone_number": "281-313-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16319 EAGLEWOOD SHADOW DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770836292",
            "telephone_number": "281-313-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "ROSE",
        "middle_name": "MARIE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-24",
        "deactivation_date": "2018-10-17",
        "reactivation_date": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "1743434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.