Rush Pediatric Neuropsychology, PLLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

RUSH PEDIATRIC NEUROPSYCHOLOGY, PLLC

Practice address

412 Plymouth Ave NE
Grand Rapids, MI 49505-6028

Phone

(616) 780-0590

Fax

(616) 984-4559

NPI assigned

Nov 2, 2022

Organization subpart

No

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

Authorized official

Name

Shana J Rush, PHD

Title

Owner

Phone

(616) 780-0590

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1740997477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056028",
            "telephone_number": "616-780-0590",
            "fax_number": "616-984-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056028",
            "telephone_number": "616-780-0590",
            "fax_number": "616-984-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSH PEDIATRIC NEUROPSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "SHANA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-780-0590",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Alexandria Ruprecht, M.S.,CCC-SLP
• Joshua Rusche
• Hayley Morgan Rusco, LLMSW
• Valeri A. Rusco, PAC
• Samara Ruse
• Adam Joseph Rush, MD
• Amy Rush, M.S., LPC
• Michael Rush, MD
• Mikayla Nicole Rush, LPC
• Rebecca Jenae Rush

• Clinical Neuropsychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.