BETTY L RUCKER (NPI# 1417213133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417213133 |
| Entity Type | Individual |
| Full Name | BETTY L RUCKER |
| Credential | LPN |
| Practice Address |
14410 Route 37 Johnston City IL 62951-3166 |
| Mailing Address |
Po Box 155 Christopher IL 62822-0155 |
| Practice Telephone | 6189836911 |
| Mailing Telephone | 6187242436 |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 043.061782 | IL | Nursing Service Providers |
| Street Address |
14410 ROUTE 37 |
| City | JOHNSTON CITY |
| State | IL |
| Zip Code | 62951-3166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174529663 | Khalid Javed | Internal Medicine | 14410 Route 37, Johnston City, IL 62951-3166 | 2005-06-21 |
| 1023575339 | Kimberly Ann Walker | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2019-02-22 |
| 1376019133 | Bradley Q Hopkins | Registered Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2018-10-19 |
| 1437664158 | Rheanne Collier | Registered Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2017-12-04 |
| 1073049391 | Amy Potts | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2017-05-05 |
| 1881129492 | Christina Harper | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2017-04-21 |
| 1306381850 | Carrie Payne | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2016-12-19 |
| 1609207422 | Natasha Nicole Youngblood | Nurse Practitioner | 14410 Route 37, Johnston City, IL 62951-3166 | 2013-12-04 |
| 1194079517 | Kenneth J. Sutton | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2012-11-07 |
| 1922352350 | Randa Deanne Roddy | Registered Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2012-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093230625 | Chrysalis Behavior Services | Behavioral Analyst | 13887 Jeffrey Mine Road, Johnston City, IL 62951 | 2017-08-04 |
| 1982888343 | Jamie Lynn Fred | Licensed Practical Nurse | 119 Gas Plant Road, Rea Clinic-duquoin, Johnston City, IL 62951 | 2007-12-20 |
| 1093166845 | Pathway House, Inc. | Assisted Living Facility | 806 W 10th St, Johnston City, IL 62951-1017 | 2016-06-23 |
| 1205907664 | Gary J Bandy | Pharmacist | 905 Grand Ave, Johnston City, IL 62951-1219 | 2006-11-09 |
| 1144355736 | Bandy Drugs | Pharmacy | 905 Grand Ave, Johnston City, IL 62951-1219 | 2007-02-22 |
| 1295020493 | Rachel Adrianne Pauls | Speech-Language Pathologist | 1108 Grand Ave, Johnston City, IL 62951-1229 | 2011-06-15 |
| 1962428516 | Johnston City Medical Clinic, S. C. | Clinic/Center | 201 W Broadway Blvd, Johnston City, IL 62951-1427 | 2006-07-15 |
| 1346363553 | Villa House, Inc | Exclusive Provider Organization | 1112 Washington Ave, Johnston City, IL 62951-1536 | 2007-04-10 |
| 1831305028 | Johnston City Comm Unit Dist 1 | Local Education Agency (LEA) | 1103 Monroe Ave, Johnston City, IL 62951-1566 | 2007-05-15 |
| 1871622118 | Jacob Schlee | Dentist | 101 E Broadway Blvd, Johnston City, IL 62951-1602 | 2007-03-04 |
| Find all providers in zip 62951 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356822555 | Betty Jane Payne | Licensed Practical Nurse | 1203 Market Ave, Johnston City, IL 62951-1842 | 2018-08-24 |
| 1023575339 | Kimberly Ann Walker | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2019-02-22 |
| 1073049391 | Amy Potts | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2017-05-05 |
| 1881129492 | Christina Harper | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2017-04-21 |
| 1306381850 | Carrie Payne | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2016-12-19 |
| 1194079517 | Kenneth J. Sutton | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2012-11-07 |
| 1902165509 | Patricia M. Henderson | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2012-05-16 |
| 1497040083 | Kayce E Rametta | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2011-06-13 |
| 1013149780 | Tammy Sue Yates | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951-3166 | 2009-08-14 |
| 1144454232 | Ashley Jean Byrley | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951 | 2009-05-05 |
| Find all providers in JOHNSTON CITY | ||||
| City | JOHNSTON CITY |
| Zip Code | 62951 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.