Healthcare Provider Details

I. General information

NPI: 1649664582
Provider Name (Legal Business Name): ANN M RUSK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN M JESPERSON MD

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5499
US

IV. Provider business mailing address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5499
US

V. Phone/Fax

Practice location:
  • Phone: 480-301-8000
  • Fax:
Mailing address:
  • Phone: 480-301-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number67403
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number67403
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number65472
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: