Emily Anne Rusticus, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704293629 Issued in MI

Practice address

2373 64TH St SW
Suite 1300
Byron Center, MI 49315-7974

Phone

(616) 685-1350

NPI assigned

Mar 30, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Emily Butler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Grandville Pediatrics, P.C.

  • Pediatrics Physician
  • Grandville, MI
  • NPI 1518931732
  NPD (past)

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1336502244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 64TH ST SW",
            "address_2": "SUITE 1300",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493157974",
            "telephone_number": "616-685-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTICUS",
        "first_name": "EMILY",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704293629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "BUTLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dawn Rodgers-de Fouw, LMSW
• Devin Rose, PHARMD
• Heather Roth, R.PH.
• Rebecca Marie Royce, NP
• Gerohnda Lynn Rushton, D.O.
• Kyleigh Rutgers
• Jennifer Ashley Saed, LLPC
• Sakshaug Group Home
• Sakshaug Group Homes LLC
• Valkyrie F Sakshaug

• Family Nurse Practitioner in Byron Center, MI
• Providers in Byron Center, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.