Louis J Rusin

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

24591 Issued in MN

Practice address

15111 Twelve Oaks Ctr Dr
Park Nicollet Clinic - Carlson
Minnetonka, MN 55305

Phone

(952) 993-4570

Fax

(952) 993-4639

NPI assigned

Dec 22, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1881670651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15111 TWELVE OAKS CTR DR",
            "address_2": "PARK NICOLLET CLINIC - CARLSON",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55305",
            "telephone_number": "952-993-4570",
            "fax_number": "952-993-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSIN",
        "first_name": "LOUIS",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "24591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sylvia Tawanda Rucker, FNP
• Kendria Jean Ruhland, DPT
• Odalys Ruiz-Sanchez, ARNP
• Sara Rukavina
• Annaria Rupnaraine, APRN
• Aaron T Rusnak, LICSW
• Maryanne Russell, NP
• Abigail Rutigliano
• Ann Ahlhauser Ryan, P.T.
• Heather Lee Ryan, FNP-BC

• Dermatology Physician in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.