Individual provider Active NPI

Michelle R Ruka, SAC-IT

  • Addiction (Substance Use Disorder) Counselor
  • Wausau, WI
National Provider Identifier
1962079731
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
18403 Issued in WI
Practice address
210 Washington St
Wausau, WI 54403-5543
Phone
(715) 845-3637
Fax
(715) 845-1911
NPI assigned
Jun 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 18403 WI Primary

Addresses

Primary practice location

210 Washington St
Wausau, WI 54403-5543

Mailing address

210 Washington St
Wausau, WI 54403-5543
Phone (715) 845-3637

Other identifiers 1

IdentifierTypeStateIssuer
00001MedicaidWI

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
18403WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1962079731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WASHINGTON ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035543",
            "telephone_number": "715-845-3637",
            "fax_number": "715-845-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WASHINGTON ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035543",
            "telephone_number": "715-845-3637",
            "fax_number": "715-845-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUKA",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.