Individual provider Active NPI

Sophia Rush, MSN, CRNP

  • Family Nurse Practitioner
  • Bloomsburg, PA
National Provider Identifier
1942518485
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SPO10177 Issued in PA
Practice address
400 E 2ND St
Bloomsburg, PA 17815-1301
Phone
(570) 389-4451
NPI assigned
Sep 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SPO10177 PA Primary

Addresses

Primary practice location

400 E 2ND St
Bloomsburg, PA 17815-1301

Mailing address

PO Box 437
19 West Market St
Tresckow, PA 18254-0437
Phone (570) 450-6623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141031000906 PA Practitioner - Nurse Practitioner 1052532280 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SPO10177PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 20, 2014 Accepting new patients
Schuylkill Health System Medical Group, Inc. Family CurrentSince Apr 1, 2019 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 20, 2014 Accepting new patients

Locations

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

200 Schuylkill Medical Plz
Pottsville, PA 17901
Phone (570) 621-9200

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1942518485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437",
            "address_2": "19 WEST MARKET ST",
            "city": "TRESCKOW",
            "state": "PA",
            "postal_code": "182540437",
            "telephone_number": "570-450-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 2ND ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151301",
            "telephone_number": "570-389-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH",
        "first_name": "SOPHIA",
        "name_prefix": "Miss",
        "credential": "MSN, CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SPO10177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.