Jacquelyn Necole Rush

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP143283 Issued in TX

Practice address

521 N Beaton St
Corsicana, TX 75110-3142

Phone

(903) 872-4777

NPI assigned

Oct 7, 2019

Last updated

Oct 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1760023139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 N BEATON ST",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751103142",
            "telephone_number": "903-872-4777",
            "fax_number": "903-872-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 N BEATON ST",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751103142",
            "telephone_number": "903-872-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH",
        "first_name": "JACQUELYN",
        "middle_name": "NECOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143283",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "AP143283",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmah Rosana, RPH
• Kelly L. Ross, DO
• Hanna Rowe, DDS
• Priya Roy Chaudhury, M.D.
• Rural Rehab Providers, LLC (Lott Physical Therapy)
• S. and M.S. LLC (Arc Hospice & Palliative Care)
• Khalid Sadeddin, D.D.S
• Stephanie Sanderson
• Kelly Sandoval, FNP-C
• Eneyine Ovezeyimi Sanni, PHARMD

• Family Nurse Practitioner in Corsicana, TX
• Providers in Corsicana, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.