Active NPI
Jennifer Rusco, FNP-BC
- Family Nurse Practitioner
- Memphis, TN
National Provider Identifier
1134597677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 277000881
- Practice address
- 50 S B B King Blvd
Memphis, TN 38103-2626 - Phone
- (901) 422-7644
- NPI assigned
- Sep 14, 2015
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 277000881 | IL | Primary |
Addresses
Primary practice location
50 S B B King Blvd
Memphis, TN 38103-2626
Mailing address
40 S Main St
Ste 1300
Memphis, TN 38103-5513
Phone (901) 422-7617
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209012912 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277000881 | IL | MD | Family Nurse Practitioner |
Interoperability endpoints
- ms_jrusco@landmarkhealth-direct.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646956800000",
"number": "1134597677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 S MAIN ST",
"address_2": "STE 1300",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381035513",
"telephone_number": "901-422-7617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 S B B KING BLVD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381032626",
"telephone_number": "901-422-7644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSCO",
"first_name": "JENNIFER",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-14",
"last_updated": "2022-03-11",
"certification_date": "2022-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "277000881",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "209012912",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.