Rustic Trails LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

RUSTIC TRAILS LLC

Practice address

200 W Highway 6
Suite 509
Waco, TX 76712-7923

Phone

(254) 399-6788

Fax

(254) 399-6766

NPI assigned

Jun 6, 2008

Last updated

Jun 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael Bumpass

Title

President

Phone

(254) 399-6788

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1932368776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W HIGHWAY 6",
            "address_2": "SUITE 509",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127923",
            "telephone_number": "254-399-6788",
            "fax_number": "254-399-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W HIGHWAY 6",
            "address_2": "SUITE 509",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127923",
            "telephone_number": "254-399-6788",
            "fax_number": "254-399-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSTIC TRAILS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "BUMPASS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-399-6788",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Antle Rushing, FNP
• Russell E Swann M.D. PA (Brazos Eye Surgery of Texas)
• Halle Tamsen Russell, ATC
• Jennifer Russell, COTA
• Joan Hannah Russell, MSN, RN, NP-C
• Mark Allen Rutledge, APN
• Audrey Alexandria Saage, R.D.L.D.
• Rachel Saage, M.S., CCC-SLP
• Saddle Creek Dental, PA
• Kalpana Sadhu

• Nursing Facility/Intermediate Care Facility in Waco, TX
• Providers in Waco, TX by specialty
• Nursing Facility/Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.