REGINA CHANNELL RUFFIN (NP) – Family Nurse Practitioner, NPI 1164084133

REGINA CHANNELL RUFFIN (NP) is a healthcare provider. based in Harvey, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 209019415 (IL). The NPI Number for REGINA CHANNELL RUFFIN (NP) is 1164084133

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
REGINA CHANNELL RUFFIN (NP)
NPI
1164084133
Phone
(708) 596-5177
Address
31 W 155TH ST
Enumeration Date
30 June 2019
Last Update Date
18 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3175284800
Graduation Year
2018 (8 years ago)
PAC ID
5294063939
Group Practice PAC ID
4183529456
Professional Enrollment ID
I20190820001418
Address ID
IL604113871CH1400XBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:6State licenses:2Digital endpointsOther names

11,637 NURSE PRACTITIONER in IL

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Provider Addresses for REGINA CHANNELL RUFFIN (NP)

  • 31, West 155th Street, Harvey, Thornton Township, Cook County, Illinois, 60426, United States

    HARVEY, IL 604263556

    Phone: (708) 596-5177

    Type: Mailing

  • 1400 Otto Blvd

    Chicago Heights, IL 604113871

    Phone: (708) 733-7200

    Fax: (708) 733-7222

    Type: Location

  • 606 Gordon Ter

    University Park, IL 604842716

    Phone: (773) 891-2372

    Type: Location

  • 1923 W GLEN PARK AVE

    GRIFFITH, IN 463193703

    Phone: (219) 922-2535

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $24.

Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Novo Nordisk Inc ($24).

Total Amount

$24

General + Research + Ownership

Payments

1

Total payment records

General Amount

$24

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Novo Nordisk Inc$24
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-01-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190820001418INurse PractitionerILTBD
I20230130000655INurse PractitionerINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 60426)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183529456View full group profile

Reviews

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Frequently asked questions

What is the registry number for REGINA CHANNELL RUFFIN (NP)?
The registry entry for REGINA CHANNELL RUFFIN (NP) shows NPI 1164084133.
Does the public listing show REGINA CHANNELL RUFFIN (NP) as active?
REGINA CHANNELL RUFFIN (NP)'s NPI record reflects an active status in NPPES.
What type of care does REGINA CHANNELL RUFFIN (NP) provide?
REGINA CHANNELL RUFFIN (NP)'s profile centers on Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to REGINA CHANNELL RUFFIN (NP)?
REGINA CHANNELL RUFFIN (NP) is associated with Harvey, Illinois in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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