NPIMap

Organization Active NPI

Samuel B Rush MD Prof Corporation Pension & Profit Sharing Plan Trust

  • Internal Medicine Physician
  • Clovis, CA
National Provider Identifier
1982926556
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00G171190 Issued in CA
Legal business name
SAMUEL B RUSH MD PROF CORPORATION PENSION & PROFIT SHARING PLAN TRUST
Practice address
684 Medical Center Dr E
Clovis, CA 93611-6806
Phone
(559) 298-3858
Fax
(559) 298-3830
NPI assigned
Feb 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Authorized official

Name
Samuel Burton RushNPI 1780622324
Title
Owner
Phone
(559) 298-3850

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 00G171190 CA Primary

Addresses

Primary practice location

684 Medical Center Dr E
Clovis, CA 93611-6806

Mailing address

PO Box 28915
Fresno, CA 93729-8915
Phone (559) 258-2800

National Provider Directory

National Provider Directory

Locations

684 N Medical Center Dr E
Clovis, CA 93611
Phone (209) 349-9506

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1982926556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28915",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937298915",
            "telephone_number": "559-258-2800",
            "fax_number": "559-253-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 MEDICAL CENTER DR E",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116806",
            "telephone_number": "559-298-3858",
            "fax_number": "559-298-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL B RUSH MD PROF CORPORATION PENSION & PROFIT SHARING PLAN TRUST",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-23",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "BURTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-298-3850"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "00G171190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.