Active NPI
Jeffery Scott Rust, P.A
- Physician Assistant
- Gilbert, AZ
National Provider Identifier
1841240207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1575
- Practice address
- 641 W Warner Rd
Gilbert, AZ 85233-7266 - Phone
- (480) 722-9828
- Fax
- (480) 722-9831
- NPI assigned
- May 10, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1575 | AZ | Primary |
Addresses
Primary practice location
641 W Warner Rd
Gilbert, AZ 85233-7266
Mailing address
1250 S Clearview Ave Ste 100
Urgent Care Exta
Mesa, AZ 85209-3378
Phone (480) 988-9108
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 764169 | Medicaid | AZ |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1575 | AZ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Valley Urgent Care,LLC | Past | Accepting new patients | |
| Emergency Physicians Professional Association LTD | Past | Accepting new patients | |
| Exigence Arizona LLC | Past | Accepting new patients | |
| East Valley Urgent Care, LLC | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Urgent Care Clinic/Center
- San Tan Valley, AZ
- NPI 1649515347
-
- Urgent Care Clinic/Center
- Phoenix, AZ
- NPI 1235481128
-
- Emergency Medicine Physician
- Phoenix, AZ
- NPI 1114931490
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bullhead City, AZ
- NPI 1558311506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440460800000",
"number": "1841240207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 S CLEARVIEW AVE STE 100",
"address_2": "URGENT CARE EXTA",
"city": "MESA",
"state": "AZ",
"postal_code": "852093378",
"telephone_number": "480-988-9108",
"fax_number": "480-813-4460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "641 W WARNER RD",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852337266",
"telephone_number": "480-722-9828",
"fax_number": "480-722-9831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUST",
"first_name": "JEFFERY",
"middle_name": "SCOTT",
"credential": "P.A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2015-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "1575",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "764169",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.