Individual provider Active NPI

Hemma Rusoff, VT

  • Vision Therapy Optometrist
  • Andover, MN
National Provider Identifier
1477725554
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
3059 Issued in MN
Practice address
2705 Bunker Lake Blvd.
Suite B102
Andover, MN 55304
Phone
(651) 492-8979
NPI assigned
Mar 28, 2008
Last updated
Mar 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 3059 MN Primary

Addresses

Primary practice location

2705 Bunker Lake Blvd.
Suite B102
Andover, MN 55304

Mailing address

7373 147TH St W
Suite 130
Apple Valley, MN 55124-7690
Phone (952) 270-8032

Other names 1

  • Ms. Karrie Ruedy Other name

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1477725554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 147TH ST W",
            "address_2": "SUITE 130",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247690",
            "telephone_number": "952-270-8032",
            "fax_number": "952-431-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 BUNKER LAKE BLVD.",
            "address_2": "SUITE B102",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "55304",
            "telephone_number": "651-492-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSOFF",
        "first_name": "HEMMA",
        "name_prefix": "Ms.",
        "credential": "VT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MN",
            "license": "3059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARRIE",
            "last_name": "RUEDY",
            "prefix": "MS.",
            "credential": "VT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Andover, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.