Physician Compare National (NPI:1154684355)

HEALTHCARE PROVIDER: STEFANIE NICOLE RUST D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1154684355
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9537398573
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140214001065
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RUST
	Individual professional last name
Provider First Name	STEFANIE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	7250 SHERIDAN RD
	Group Practice or individual's line 1 address
City	WHITE HALL
	Group Practice or individual's city
State	AR
	Group Practice or individual's state
Zip Code	716023224
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	040118
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NEA BAPTIST MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	040085
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HELENA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y