Active NPI
Marnie Rustemeyer
- Specialist
- Charleston, WV
National Provider Identifier
1992262257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 50074735
- Practice address
- 1306 Kanawha Blvd E Ste 1001306
Charleston, WV 25301-3000 - Phone
- (917) 753-6225
- NPI assigned
- Feb 22, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 50074735 | NY | Primary |
Addresses
Primary practice location
1306 Kanawha Blvd E Ste 1001306
Charleston, WV 25301-3000
Mailing address
321 S Pointe Dr
Charleston, WV 25314-2479
Phone (646) 346-3211
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50074735 | NY | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medi Ink, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Other Specialist/Technologist
- Charleston, WV
- NPI 1326805565
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550793600000",
"number": "1992262257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 S POINTE DR",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253142479",
"telephone_number": "646-346-3211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1306 KANAWHA BLVD E STE 1001306",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253013000",
"telephone_number": "917-753-6225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSTEMEYER",
"first_name": "MARNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-22",
"last_updated": "2019-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "50074735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.