Eric M. Rustad, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

18992 Issued in TX

Practice address

2228 Mistletoe Ave
Fort Worth, TX 76110-1145

Phone

(817) 939-7307

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952457079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 MISTLETOE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101145",
            "telephone_number": "817-939-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 MISTLETOE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101145",
            "telephone_number": "817-939-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTAD",
        "first_name": "ERIC",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "18992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10048486",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Russell, BSN, RN
• Travis Odell Russell Jr., PTA
• Kourtney Russo, FNP-C
• Weldon K Russo, OTR
• Adrienne Rust, CPNP
• Ruth R. Wiley, D.O., P.a.
• Shelby Rutherford
• David M Rutledge, MD
• Erin Rutledge, PA-C
• Peter L Rutledge, M.D.

• Speech-Language Pathologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.