Active NPI
Thomas William Rusing, M.D.
- Surgery Physician
- Prescott, AZ
National Provider Identifier
1114933694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 14828
- Practice address
- 811 Ainsworth Dr
Suite 103
Prescott, AZ 86301-1687 - Phone
- (928) 771-5550
- Fax
- (928) 445-9209
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 14828 | AZ | Primary |
| Colon & Rectal Surgery Physician | 208C00000X | 14828 | AZ |
Addresses
Primary practice location
811 Ainsworth Dr
Suite 103
Prescott, AZ 86301-1687
Mailing address
PO Box 10880
Prescott, AZ 86304-0880
Phone (928) 759-5987
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0185310 | Other | AZ | BLUE CROSS BLUE SHIELD ID |
| 21-113- K828 | Other | AZ | STATE COMPENSATION ID# |
| 257990 | Other | AZ | AHCCCS ID # |
| 11330927 | Other | AZ | CAQH PROVIDER ID # |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14828 | AZ | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474329600000",
"number": "1114933694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10880",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863040880",
"telephone_number": "928-759-5987",
"fax_number": "928-458-2039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 AINSWORTH DR",
"address_2": "SUITE 103",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011687",
"telephone_number": "928-771-5550",
"fax_number": "928-445-9209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSING",
"first_name": "THOMAS",
"middle_name": "WILLIAM",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2016-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AZ",
"license": "14828",
"primary": true
},
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "AZ",
"license": "14828",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD ID",
"identifier": "0185310",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE COMPENSATION ID#",
"identifier": "21-113- K828",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS ID #",
"identifier": "257990",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH PROVIDER ID #",
"identifier": "11330927",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.