Active NPI
Courtney Rusch
- Pediatric Gastroenterology Physician
- Royal Oak, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 4301513350
- Practice address
- 110 E 2ND St
Royal Oak, MI 48067-2694 - Phone
- (248) 546-2110
- NPI assigned
- Jun 25, 2019
- Last updated
- Jul 16, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2019023134 | MO | |
| Pediatrics Physician | 208000000X | 01088085A | IN | |
| Pediatrics Physician | 208000000X | 4301513350 | MI | |
| Pediatric Gastroenterology Physician | 2080P0206X | 4301513350 | MI | Primary |
Addresses
Primary practice location
110 E 2ND St
Royal Oak, MI 48067-2694
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806
Other practice location 1
1 Childrens Pl # 3S34
Saint Louis, MO 63110-1002
Phone (314) 454-6006
Other practice location 2
705 Riley Hospital Drive
Roc 4210
Indianapolis, IN 46202-5109
Phone (317) 944-2078
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01088085A | IN | MD | Pediatrics Physician |
| 2019023134 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Health System | Current | Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| Henry Ford Maplegrove Center | Past | Accepting new patients |
Locations
1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
110 E 2nd St
Royal Oak, MI 48067
Phone (248) 546-2110
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- Gastroenterology Physician
- Detroit, MI
- NPI 1205909892
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
dba Henry Ford Health System
- Children's Substance Abuse Rehabilitation Facility
- West Bloomfield, MI
- NPI 1295767630
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752624000000",
"number": "1821659483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FORD PL STE 3A",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023450",
"telephone_number": "313-874-4806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 E 2ND ST",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480672694",
"telephone_number": "248-546-2110"
}
],
"practiceLocations": [
{
"address_1": "1 Childrens Pl # 3S34",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631101002",
"country_code": "US",
"telephone_number": "314-454-6006",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "705 Riley Hospital Drive",
"address_2": "ROC 4210",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462025109",
"country_code": "US",
"telephone_number": "317-944-2078",
"fax_number": "317-968-1055",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSCH",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-25",
"last_updated": "2025-07-16",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2019023134",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01088085A",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301513350",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "MI",
"license": "4301513350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.