SUSAN KIMBERLY MOORE RUCKER MD NPI 1104967306

NPI Information

  • NPI: 1104967306
  • Provider Name: SUSAN KIMBERLY MOORE RUCKER, MD
  • Classification: Pediatrics - 208000000X
  • Entity Type: Individual
  • Address: 500 DECATUR PIKE
    ATHENS, TN
    ZIP 37303
  • Phone: (423) 745-2500

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NPI Details

Susan Kimberly Moore Rucker, MD is a pediatrics in Athens, TN. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Susan Kimberly Moore Rucker, MD NPI is 1104967306. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

500 DECATUR PIKE
ATHENS, TN
ZIP 37303-514
Phone: (423) 745-2500
Fax: (423) 745-2571

The enumeration date for this NPI number is 2/9/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsMD28936TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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