Individual provider Active NPI

Nikita Rusk, COSMETOLOGIST

  • Prosthetics Case Management
  • Dallas, TX
National Provider Identifier
1447967807
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
Practice address
1009 W Davis St
Dallas, TX 75208-5030
Phone
(469) 785-1117
NPI assigned
Nov 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193400000X SINGLE SPECIALTY GROUP 1744P3200X Primary

Addresses

Primary practice location

1009 W Davis St
Dallas, TX 75208-5030

Mailing address

1009 W Davis St
Dallas, TX 75208-5030
Phone (469) 785-1117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1447967807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 W DAVIS ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752085030",
            "telephone_number": "469-785-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 W DAVIS ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752085030",
            "telephone_number": "469-785-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSK",
        "first_name": "NIKITA",
        "credential": "COSMETOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.