Oswarld Niyiduha Irakunda Rusibamayila

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041405733 Issued in IL

Practice address

1500 W Northmoor Rd
Peoria, IL 61614-3435

Phone

(309) 691-2200

NPI assigned

Jan 3, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1528575248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7345 WOODLAND DR STE D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781737",
            "telephone_number": "317-286-2885",
            "fax_number": "317-536-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W NORTHMOOR RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143435",
            "telephone_number": "309-691-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSIBAMAYILA",
        "first_name": "OSWARLD",
        "middle_name": "NIYIDUHA IRAKUNDA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "893242",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN273461",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041405733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Rupert, CRNA
• Nancy Catherine Rupert, MA, CCC-SLP
• Leslie J Rusch-Bayer
• Sara Rusch, MD
• Andrew Ryne Rush, LSW
• Angelica Rusilowski, DO, MPH
• Lauren Ashley Rusk, MS, RD, LDN
• Brande Ruskusky, CNM, APN
• Kasey Lynn Russell
• Kristina R Russell, PT

• Registered Nurse in Peoria, IL
• Providers in Peoria, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; 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.