Kaleb Paul Rush, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.004880RX Issued in OH

Practice address

101 E Main St
Barnesville, OH 43713-1005

Phone

(740) 425-5165

NPI assigned

Oct 26, 2016

Last updated

Oct 26, 2016By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1902358849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50354 STATE ROUTE 145",
            "city": "WOODSFIELD",
            "state": "OH",
            "postal_code": "437939217",
            "telephone_number": "740-472-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MAIN ST",
            "city": "BARNESVILLE",
            "state": "OH",
            "postal_code": "437131005",
            "telephone_number": "740-425-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH",
        "first_name": "KALEB",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004880RX",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Counseling & Medation Services
• Tracey Lynn Powell, MSN, FNP-BC
• Pratap K. Souri, M.D., Inc.
• Bradley D Quamme, MD
• Le Ann Marie Rinehart, LPN
• Abhishek Shahi, M.B.B.S. (M.D.)
• Penelope (Penny) Dawn Shepherd, LPCC/S
• Angela Maria Smith, LPN
• Hope Marie Smith, STNA
• Pratap Kumar Souri, MD

• Physician Assistant in Barnesville, OH
• Providers in Barnesville, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.