Active NPI
Sheldon Elizabeth Rudisill, PA-C
- Physician Assistant
- Hendersonville, NC
National Provider Identifier
1033755780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1721 Brevard Rd
Hendersonville, NC 28791-3201 - Phone
- (828) 698-2688
- NPI assigned
- Nov 18, 2019
- Last updated
- Jan 9, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MPA.3400 | SC | |
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1721 Brevard Rd
Hendersonville, NC 28791-3201
Mailing address
214 Carolina Club Dr
Spartanburg, SC 29306-6604
Phone (864) 590-3041
Other practice location 1
81 Pointe Cir Ste D
Greenville, SC 29615-3505
Phone (706) 421-8554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3400 | SC | MD | Chiropractor |
| MPA.3400 | SC | MD | Physician Assistant |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578528000000",
"number": "1033755780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 CAROLINA CLUB DR",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293066604",
"telephone_number": "864-590-3041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 BREVARD RD",
"city": "HENDERSONVILLE",
"state": "NC",
"postal_code": "287913201",
"telephone_number": "828-698-2688"
}
],
"practiceLocations": [
{
"address_1": "81 Pointe Cir Ste D",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "SC",
"postal_code": "296153505",
"country_code": "US",
"telephone_number": "706-421-8554",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUDISILL",
"first_name": "SHELDON",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-18",
"last_updated": "2020-01-09",
"certification_date": "2020-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "MPA.3400",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hendersonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.