Connie J Rusk, APRN

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

77980 Issued in CO

Practice address

13112 Saint Paul Dr
Thornton, CO 80241-2121

Phone

(303) 503-6671

Fax

(303) 839-7360

NPI assigned

Jun 19, 2009

Last updated

Nov 15, 2014By 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 4

Addresses

Other names 1

• Connie J Hendrix Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416009600000",
    "number": "1215164066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13112 SAINT PAUL DR",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412121",
            "telephone_number": "303-503-6671",
            "fax_number": "303-839-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13112 SAINT PAUL DR",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412121",
            "telephone_number": "303-503-6671",
            "fax_number": "303-839-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSK",
        "first_name": "CONNIE",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2014-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "CO",
            "license": "77980",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "KS",
            "license": "53-44709-091",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CO",
            "license": "77980",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "KS",
            "license": "53-44709-091",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "HENDRIX",
            "middle_name": "J",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Critical Care Neonatal Nurse Practitioner in Thornton, CO
• Providers in Thornton, CO by specialty
• Critical Care Neonatal Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.