Individual provider Active NPI

Sandra Rusnak, FNP

  • Nurse Practitioner
  • Clermont, FL
National Provider Identifier
1699435164
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11017138 Issued in FL
Practice address
706 E Grand Hwy
Clermont, FL 34711-3708
Phone
(352) 557-4965
NPI assigned
Dec 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9454456 FL
Nurse Practitioner 363L00000X APRN11017138 FL Primary

Addresses

Primary practice location

706 E Grand Hwy
Clermont, FL 34711-3708

Mailing address

706 E Grand Hwy
Clermont, FL 34711-3708
Phone (352) 557-4965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20251121003793 TN Practitioner - Nurse Practitioner 4486146982 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

277 E Broadway Blvd
Jefferson City, TN 37760-2810
Phone (615) 388-1571

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9454456FLMDRegistered Nurse
39129TNMDSurgery Physician
APRN11017138FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Oct 20, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Oct 20, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Oct 20, 2025 Accepting new patients
Upperline Healthcare, PC Nurse Practitioner CurrentSince Oct 20, 2025 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Past Accepting new patients
PM Pediatrics PA PastSince Jan 1, 2022 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

277 E Broadway Blvd
Jefferson City, TN 37760
Phone (865) 262-9294

Organizations & group practices 6

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": "1640563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1699435164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 E GRAND HWY",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113708",
            "telephone_number": "352-557-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 E GRAND HWY",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113708",
            "telephone_number": "352-557-4965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSNAK",
        "first_name": "SANDRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-27",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9454456",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11017138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.