Rusty Lee Musick II
Individual provider Active NPI Peer Specialist · Fairdale, WV
NPI 1265300032 · NPPES record last updated Oct 24, 2025
Key facts
- NPI
- 1265300032
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- 24-948 (WV)
- Practice address
- 2121 Bolt Rd
Fairdale, WV 25839-9610 - Phone
- (304) 573-3134
- NPI assigned
- Oct 24, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-948 | WV | MD | Peer Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 24-948 | WV | Yes |
Addresses
Primary practice location
2121 Bolt Rd
Fairdale, WV 25839-9610
Mailing address
2121 Bolt Rd
Fairdale, WV 25839-9610
Phone (304) 573-3134
Other providers in Fairdale, WV
- Mona Divers
- Mary Catherine Hood
- Sarah May Johnson
- Alyssa Lynae McGhee
- Amanda Dawn McKnight
- Julia Nelson
- Karen Rickard
- April R Sauls
- Chelsey Young
All providers in Fairdale, WV · Peer Specialist in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.