Mark D Rusch, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1105 Issued in WI

Practice address

9200 W Wisconsin Ave
Dept of Plastic Surgery
Milwaukee, WI 53226-3522

Phone

(414) 805-5476

Fax

(414) 805-5850

NPI assigned

May 26, 2006

Last updated

Aug 22, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1881640043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPT OF PLASTIC SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-5476",
            "fax_number": "414-805-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPT OF PLASTIC SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-5476",
            "fax_number": "414-805-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSCH",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "000000105",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881640043",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lasharai Taza Rupert
• Kris Ruppin, PHARMD
• Carly Ruscello, MS,RD,CD
• Deanna Rusch
• Kathleen Mary Rusch, PH.D.
• Richard L Rusch, M.D.
• Robert David Rusch, PA-C
• Susan W Rusch, MD
• Nicole Marie Rusche, CCC-SLP
• Felicia Rush, LMT

• Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.