Andre Rucks

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

715 N College Ave
El Dorado, AR 71730-4403

Phone

(870) 312-6873

Fax

(870) 777-3104

NPI assigned

Dec 13, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alvin Le Andre Rucks Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southwest Arkansas Counseling and Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Texarkana, AR
  • NPI 1598761553
  NPD
• Southwest Arkansas Counseling and Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Hope, AR
  • NPI 1295985208
  NPD (past)

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1972310951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E 20TH ST",
            "city": "HOPE",
            "state": "AR",
            "postal_code": "718018217",
            "telephone_number": "870-777-9051",
            "fax_number": "870-777-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N COLLEGE AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304403",
            "telephone_number": "870-312-6873",
            "fax_number": "870-777-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKS",
        "first_name": "ANDRE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-13",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALVIN",
            "last_name": "RUCKS",
            "middle_name": "LE ANDRE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kiana Webb Robinson, PLMSW
• Kelsie Rogers, PHARM D.
• Gena Rene Roshto, MS, OTR/L
• Karen Ann Ross, OTA/L
• Tambre Dee Roush, LMSW
• Heather Michele Russell
• Ruthie Gibson
• Ryan Hanry, DDS, PA
• Sarah Saffold
• Sama Healthcare Services, PA

• Case Manager/Care Coordinator in El Dorado, AR
• Providers in El Dorado, AR by specialty
• Case Manager/Care Coordinator in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.