Active NPI
Jeffery Rush
- Neurological Surgery Physician
- Breckenridge, CO
National Provider Identifier
1922540178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- G22624
- Practice address
- 400 N Park Ave
10 B
Breckenridge, CO 80424-8709 - Phone
- (970) 453-5631
- NPI assigned
- Nov 4, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | G22624 | CA | Primary |
Addresses
Primary practice location
400 N Park Ave
10 B
Breckenridge, CO 80424-8709
Mailing address
400 N Park Ave
10 B
Breckenridge, CO 80424-8709
Phone (970) 453-5631
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G22624 | CA | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478217600000",
"number": "1922540178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N PARK AVE",
"address_2": "10 B",
"city": "BRECKENRIDGE",
"state": "CO",
"postal_code": "804248709",
"telephone_number": "970-453-5631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N PARK AVE",
"address_2": "10 B",
"city": "BRECKENRIDGE",
"state": "CO",
"postal_code": "804248709",
"telephone_number": "970-453-5631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSH",
"first_name": "JEFFERY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-04",
"last_updated": "2016-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "CA",
"license": "G22624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Breckenridge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.