Teresa E Rush, FNP BC
Individual provider Active NPI Family Nurse Practitioner · Ada, OH
NPI 1821159575 · NPPES record last updated Jun 13, 2018
Key facts
- NPI
- 1821159575
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN.CNP.08376 (OH)
- Practice address
- 604 W North Ave
Ada, OH 45810 - Phone
- (419) 634-0431
- Fax
- (419) 634-0540
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP08376 | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP08376 | OH | |
| Family Nurse Practitioner | 363LF0000X | NP08376 | OH | |
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.08376 | OH | Yes |
Addresses
Primary practice location
604 W North Ave
Ada, OH 45810
Mailing address
604 W North Ave
Ada, OH 45810-1041
Phone (419) 634-0431
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000527472 | Other | OH | ANTHEM BCBS |
| 11501495 | Other | OH | CAQH |
| 2623441 | Medicaid | OH | |
| 1821159575 | Other | OH | ANTHEM |
| 000000384645 | Other | OH | ANTHEM |
Other providers in Ada, OH
- Michael Pugacz
- Daniel Reyes
- Rite Aid of Ohio Inc
- Andrew M Roecker
- Michael James Rush
- Lee B Savino
- Tracy Scalfaro
- Margaret Schimmoeller
- Andrew Thomas Schroeder
- Ethan Schwipps
All providers in Ada, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.