NPIMap

Organization Active NPI

Troy E. Rustad, MD, PC

  • Dermatology Physician
  • Lincoln, NE
National Provider Identifier
1255751814
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
19665 Issued in NE
Legal business name
TROY E. RUSTAD, MD, PC
Practice address
1919 S 40TH St
Suite 330
Lincoln, NE 68506-5243
Phone
(402) 420-0101
Fax
(402) 420-9933
NPI assigned
Apr 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Authorized official

Name
Dr. Troy Elliott Rustad, M.D.
Title
Ceo
Phone
(612) 227-8769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 19665 NE Primary

Addresses

Primary practice location

1919 S 40TH St
Suite 330
Lincoln, NE 68506-5243

Mailing address

PO Box 23108
Lincoln, NE 68542-3108
Phone (402) 420-0101

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398124800000",
    "number": "1255751814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23108",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685423108",
            "telephone_number": "402-420-0101",
            "fax_number": "402-420-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S 40TH ST",
            "address_2": "SUITE 330",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685065243",
            "telephone_number": "402-420-0101",
            "fax_number": "402-420-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROY E. RUSTAD, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-22",
        "last_updated": "2014-04-22",
        "status": "A",
        "authorized_official_last_name": "RUSTAD",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "ELLIOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-227-8769",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NE",
            "license": "19665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.