Individual provider Active NPI

Janice Gilbert Rushton, PAC

  • Physician Assistant
  • Livonia, MI
National Provider Identifier
1669703989
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005690 Issued in MI
Practice address
19900 Haggerty Rd
Livonia, MI 48152-1054
Phone
(734) 432-7811
NPI assigned
Jan 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601005690 MI Primary

Addresses

Primary practice location

19900 Haggerty Rd
Livonia, MI 48152-1054

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other identifiers 1

IdentifierTypeStateIssuer
1669703989MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120313000100 MI Practitioner - Physician Assistant 0042479909 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Physician Assistant CurrentSince Jan 1, 2017 Accepting new patients
Henry Ford Health System CurrentSince Feb 27, 2012 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Feb 27, 2012 Accepting new patients

Locations

16045 Collection Ctr Dr
Chicago, IL 60693

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

6001 W Outer Dr
Ste 121
Detroit, MI 48235
Phone (313) 966-3222

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

1560 E Maple Rd
Ste 400
Troy, MI 48083

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1669703989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 HAGGERTY RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521054",
            "telephone_number": "734-432-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSHTON",
        "first_name": "JANICE",
        "middle_name": "GILBERT",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669703989",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.