Individual provider Active NPI

Dawn Michelle Rush-Wilde, ARNP

  • Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1619931664
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP2933822 Issued in FL
Practice address
3190 N McMullen Booth Rd Ste 200
Clearwater, FL 33761-2013
Phone
(813) 855-2900
Fax
(813) 855-2990
NPI assigned
Apr 14, 2006
Last updated
Mar 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP2933822 FL Primary

Addresses

Primary practice location

3190 N McMullen Booth Rd Ste 200
Clearwater, FL 33761-2013

Mailing address

3190 N McMullen Booth Rd Ste 200
Clearwater, FL 33761-2013
Phone (813) 855-2900

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040503000095 FL Practitioner - Nurse Practitioner 4688662497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ms and Neuromuscular Center of Excellence LLCGroup PAC ID 1951619154, 6 clinicians

Practice addresses (Care Compare)

3190 N McMullen Booth Rd
Suite 200
Clearwater, FL 33761-2013
Phone (813) 855-2900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP2933822FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ms & Neuromuscular Center of Excellence LLC CurrentSince May 1, 2017 Accepting new patients
Nautilus Health Care Group, LLC Past Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients
Dawn P Rush, MD PLLC PastSince Aug 11, 2005 Accepting new patients
Charles K Friedman DO PA PastSince Jul 1, 2012 Accepting new patients

Locations

3190 N McMullen Booth Rd
Ste 200
Clearwater, FL 33761
Phone (727) 447-7786

3180 Curlew Rd
Unit 201
Oldsmar, FL 34677
Phone 8138552900 ext. 108

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dawn.rush-wilde.1@32973.direct.athenahealth.com

Organizations & group practices 5

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 3

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1619931664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3190 N MCMULLEN BOOTH RD STE 200",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612013",
            "telephone_number": "813-855-2900",
            "fax_number": "813-855-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 N MCMULLEN BOOTH RD STE 200",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612013",
            "telephone_number": "813-855-2900",
            "fax_number": "813-855-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH-WILDE",
        "first_name": "DAWN",
        "middle_name": "MICHELLE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2933822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.