Active NPI
Cynthia Potter Rush, M.A., HSP
- Clinical Psychologist
- Hurlburt Field, FL
National Provider Identifier
1114075637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0000011297
- Practice address
- 223 Cody Ave BLDG 90310
Hurlburt Field, FL 32544-5302 - Phone
- (850) 884-8032
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0000011297 | TN | Primary |
Addresses
Primary practice location
223 Cody Ave BLDG 90310
Hurlburt Field, FL 32544-5302
Mailing address
775 Gulf Shore Dr Unit 8238
Destin, FL 32541-5424
Phone (615) 579-4985
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000011297 | TN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654732800000",
"number": "1114075637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "775 GULF SHORE DR UNIT 8238",
"city": "DESTIN",
"state": "FL",
"postal_code": "325415424",
"telephone_number": "615-579-4985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 CODY AVE BLDG 90310",
"city": "HURLBURT FIELD",
"state": "FL",
"postal_code": "325445302",
"telephone_number": "850-884-8032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSH",
"first_name": "CYNTHIA",
"middle_name": "POTTER",
"name_prefix": "Ms.",
"credential": "M.A., HSP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2022-06-09",
"certification_date": "2022-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "0000011297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hurlburt Field, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.