Individual provider Active NPI

Casey Nicole Rust, M.D.

  • Family Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1417310632
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
145847 Issued in FL
Practice address
2911 Roberts Ave
Tallahassee, FL 32310-5007
Phone
(850) 644-1543
Fax
(855) 230-7402
NPI assigned
Apr 4, 2016
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 145847 FL Primary

Addresses

Primary practice location

2911 Roberts Ave
Tallahassee, FL 32310-5007

Mailing address

2911 Roberts Ave
Tallahassee, FL 32310-5007
Phone (850) 644-1543

Other practice location 1

4449 Meandering Way
Tallahassee, FL 32308-5740
Phone (850) 644-1543

Other names 1

  • Casey Nicole Burnette Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201223000539 FL Practitioner - Family Practice 8224310552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Medical Practice Plan IncGroup PAC ID 3971608993, 27 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2911 Roberts Ave
Tallahassee, FL 32310-5007
Phone (850) 644-1543

5103 Cold Harbor Dr
Tallahassee, FL 32312-4148
Phone (850) 270-2159

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.33 of 100Reported as group
Quality
89.31
Promoting interoperability
100
Improvement activities
40
Cost
68.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
145847FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Practice Plan Inc CurrentSince Aug 26, 2020 Accepting new patients

Locations

1115 W Call St
Tallahassee, FL 32304
Phone (850) 644-1543

1115 W Call St
Ste 4300
Tallahassee, FL 32304

2911 Roberts Ave
Tallahassee, FL 32310
Phone (850) 644-1542

4449 Meandering Way
Tallahassee, FL 32308
Phone (850) 640-1416

Interoperability endpoints

  • Direct secure messaging: casey.rust.1@19268.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Westminster OaksTallahassee, FL, CCN 105854 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Dec 1, 2022
Apr 16, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1417310632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 ROBERTS AVE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323105007",
            "telephone_number": "850-644-1543",
            "fax_number": "850-645-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 ROBERTS AVE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323105007",
            "telephone_number": "850-644-1543",
            "fax_number": "855-230-7402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4449 Meandering Way",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085740",
            "country_code": "US",
            "telephone_number": "850-644-1543",
            "fax_number": "850-645-0577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUST",
        "first_name": "CASEY",
        "middle_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "145847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "BURNETTE",
            "middle_name": "NICOLE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.