NPIMap

Organization Active NPI

Paul Rust Inc.

  • Clinical Social Worker
  • Fort Smith, AR
National Provider Identifier
1184657108
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C237 Issued in AR
Legal business name
PAUL RUST INC.
Practice address
5111 Rogers Ave.
Suite 504
Fort Smith, AR 72903
Phone
(479) 484-1111
Fax
(479) 484-1111
NPI assigned
Jul 10, 2006
Last updated
Aug 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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

Authorized official

Name
Paul Wesley Rust, LCSW, LMFTNPI 1871750950
Title
President/Owner
Phone
(479) 484-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C237 AR Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X M9803014 AR

Addresses

Primary practice location

5111 Rogers Ave.
Suite 504
Fort Smith, AR 72903

Mailing address

5111 Rogers Ave.
Suite 504
Fort Smith, AR 72903
Phone (479) 484-1111

Other identifiers 1

IdentifierTypeStateIssuer
5G027OtherARMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080812000238 AR Part B Supplier - Clinic/Group Practice 1355416256 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Smith, AR

National Provider Directory

National Provider Directory

Locations

5111 Rogers Ave
Ste 504
Fort Smith, AR 72903
Phone (479) 285-5241

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219622400000",
    "number": "1184657108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 ROGERS AVE.",
            "address_2": "SUITE 504",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72903",
            "telephone_number": "479-484-1111",
            "fax_number": "479-484-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 ROGERS AVE.",
            "address_2": "SUITE 504",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72903",
            "telephone_number": "479-484-1111",
            "fax_number": "479-484-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL RUST INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-08-25",
        "status": "A",
        "authorized_official_last_name": "RUST",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "WESLEY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "479-484-1111",
        "authorized_official_credential": "LCSW, LMFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "C237",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "AR",
            "license": "M9803014",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5G027",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.