Active NPI
Corey D Rustin, FNP
- Nurse Practitioner
- High Point, NC
National Provider Identifier
1730146044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5001113
- Practice address
- 1814 Westchester Dr
Ste 301
High Point, NC 27262-7299 - Phone
- (336) 802-2025
- Fax
- (336) 802-2026
- NPI assigned
- Apr 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 01113 | NC | |
| Nurse Practitioner | 363L00000X | 5001113 | NC | Primary |
Addresses
Primary practice location
1814 Westchester Dr
Ste 301
High Point, NC 27262-7299
Mailing address
1701 Westchester Dr
Ste 850
High Point, NC 27262-7008
Phone (336) 802-2400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1212660004 | Other | NC | DME |
| 7004782 | Medicaid | NC |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01113 | NC | MD | Nurse Practitioner |
| 5001113 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Health Care PA | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Statesville, NC
- NPI 1275914046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1730146044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 WESTCHESTER DR",
"address_2": "STE 850",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "272627008",
"telephone_number": "336-802-2400",
"fax_number": "336-802-2534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1814 WESTCHESTER DR",
"address_2": "STE 301",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "272627299",
"telephone_number": "336-802-2025",
"fax_number": "336-802-2026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSTIN",
"first_name": "COREY",
"middle_name": "D",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-28",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "01113",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5001113",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DME",
"identifier": "1212660004",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7004782",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in High Point, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.