Individual provider Active NPI

Robert Randall Rusher, MD

  • Pulmonary Disease Physician
  • Duluth, GA
National Provider Identifier
1578767596
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
066315 Issued in GA
Practice address
3650 Steve Reynolds Blvd.
Kaiser Permanente Gwinnett Medical Center
Duluth, GA 30096
Phone
(803) 799-5022
Fax
(803) 799-5890
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34083 SC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 34083 SC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 22267 MD
Pulmonary Disease Physician 207RP1001X 34083 SC
Pulmonary Disease Physician 207RP1001X 22267 MD
Pulmonary Disease Physician 207RP1001X 066315 GA Primary

Addresses

Primary practice location

3650 Steve Reynolds Blvd.
Kaiser Permanente Gwinnett Medical Center
Duluth, GA 30096

Mailing address

3495 Piedmont Road, NE
Nine Piedmont Center
Atlanta, GA 30305
Phone (404) 364-7070

Other identifiers 2

IdentifierTypeStateIssuer
340839MedicaidSC
AA76842603OtherSCMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140918001585 GA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7618140344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Boston University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

1745 Peachtree St NE
Suite U
Atlanta, GA 30309-2479
Phone (404) 379-1105

2400 Mount Zion Pkwy
Jonesboro, GA 30236-2500
Phone (770) 603-3685

2470 Mount Zion Pkwy
BLDG 200
Jonesboro, GA 30236-2500
Phone (770) 527-9031

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

3650 Steve Reynolds Blvd
Duluth, GA 30096-4506
Phone (770) 931-6026

5665 Peachtree Dunwoody Rd
Atlanta, GA 30342-1764
Phone (404) 364-7285

750 Townpark LN NW
Kennesaw, GA 30144-5579
Phone (770) 514-5405

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34083SCMDInternal Medicine Physician
066315GAMDPulmonary Disease Physician
22267MDMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Internal Medicine CurrentSince Jun 22, 2014 Accepting new patients
Department of Internal Medicine Internal Medicine Past Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

3650 Steve Reynolds Blvd
Duluth, GA 30096
Phone (770) 931-6010

2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3645

Organizations & group practices 2

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 1

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1578767596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD, NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-364-7070",
            "fax_number": "803-540-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 STEVE REYNOLDS BLVD.",
            "address_2": "KAISER PERMANENTE GWINNETT MEDICAL CENTER",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "803-799-5022",
            "fax_number": "803-799-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSHER",
        "first_name": "ROBERT",
        "middle_name": "RANDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "34083",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "34083",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MD",
            "license": "22267",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "34083",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MD",
            "license": "22267",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "066315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340839",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AA76842603",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3650 Steve Reynolds Blvd.",
            "address_2": "Kaiser Permanente Gwinnett Medical Center",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.