Active NPI
Brande Ruskusky, CNM, APN
- Midwife
- Peoria, IL
National Provider Identifier
1972837862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 209.007763
- Practice address
- 1111 E Melbourne Ave
Peoria, IL 61603-2027 - Phone
- (309) 258-3216
- NPI assigned
- Sep 24, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Midwife | 176B00000X | 209.007763 | IL | Primary |
Addresses
Primary practice location
1111 E Melbourne Ave
Peoria, IL 61603-2027
Mailing address
1111 E Melbourne Ave
Peoria, IL 61603-2027
Phone (309) 258-3216
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
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.007763 | IL | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253750400000",
"number": "1972837862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 E MELBOURNE AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616032027",
"telephone_number": "309-258-3216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 E MELBOURNE AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616032027",
"telephone_number": "309-258-3216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSKUSKY",
"first_name": "BRANDE",
"name_prefix": "Mrs.",
"credential": "CNM, APN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-24",
"last_updated": "2009-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "IL",
"license": "209.007763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.