Amanda Rusch, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13740-33 Issued in WI

Practice address

551 Kroll Rd
Sobieski, WI 54171-9734

Phone

(920) 609-5696

NPI assigned

Mar 21, 2023

Last updated

Mar 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  WI

  Medicare reassignment NPD

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1114629359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 KROLL RD",
            "city": "SOBIESKI",
            "state": "WI",
            "postal_code": "541719734",
            "telephone_number": "920-609-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 KROLL RD",
            "city": "SOBIESKI",
            "state": "WI",
            "postal_code": "541719734",
            "telephone_number": "920-609-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSCH",
        "first_name": "AMANDA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "13740-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Elliott, MS
• Elizabeth Hock
• Elizabeth Krautkramer, MSW, LCSW
• Theresa Aurelia Schulte-Campbell

• Family Nurse Practitioner in Sobieski, WI
• Providers in Sobieski, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.