Shana J. Rush, PHD CCC-SLP

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

6301013545 Issued in MI

Practice address

412 Plymouth Ave NE
Grand Rapids, MI 49505-6028

Phone

(616) 780-0590

Fax

(616) 984-4559

NPI assigned

Oct 16, 2009

Last updated

May 12, 2023By 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 2

Addresses

Other identifiers 1

Other names 1

• Dr. Shana J. Asbell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rush Pediatric Neuropsychology, PLLC

  • Clinical Neuropsychologist
  • Grand Rapids, MI
  • NPI 1740997477
  Authorized official Same address or phone

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1306171814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056028",
            "telephone_number": "616-780-0590",
            "fax_number": "616-984-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056028",
            "telephone_number": "616-780-0590",
            "fax_number": "616-984-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH",
        "first_name": "SHANA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PHD CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2023-05-12",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013545",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301013545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "6301013545",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANA",
            "last_name": "ASBELL",
            "middle_name": "J.",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adam Joseph Rush, MD
• Amy Rush, M.S., LPC
• Michael Rush, MD
• Mikayla Nicole Rush, LPC
• Rebecca Jenae Rush
• Taylor Louise Rushing
• Linda Marie Rusiecki, DPT
• Andrew J Rusk, MD
• Sara Russcher, MD
• Mildred Rebecca Russell-Emery, LBSW

• Clinical Neuropsychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.