Active NPI
Molly Lynn Rusch, RDN
- Registered Dietitian
- Centreville, MD
National Provider Identifier
1710122411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D02275
- Practice address
- 120 McKenney LN
Centreville, MD 21617-2139 - Phone
- (410) 279-0621
- NPI assigned
- Dec 9, 2008
- Last updated
- Oct 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D02275 | MD | Primary |
Addresses
Primary practice location
120 McKenney LN
Centreville, MD 21617-2139
Mailing address
600-B Abruzzi Drive
PMB #120
Chester, MD 21619
Phone (410) 279-0621
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D02275 | MD | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tidewater Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
600B Abruzzi Dr
Chester, MD 21619
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602892800000",
"number": "1710122411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600-B ABRUZZI DRIVE",
"address_2": "PMB #120",
"city": "CHESTER",
"state": "MD",
"postal_code": "21619",
"telephone_number": "410-279-0621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 MCKENNEY LN",
"city": "CENTREVILLE",
"state": "MD",
"postal_code": "216172139",
"telephone_number": "410-279-0621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSCH",
"first_name": "MOLLY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-09",
"last_updated": "2020-10-17",
"certification_date": "2020-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "D02275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centreville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.