Active NPI
Susan S Rupp, M.D.
- Internal Medicine Physician
- Lakewood, CO
National Provider Identifier
1073961710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 21067
- Practice address
- 1840 S Manor LN
Lakewood, CO 80232-7144 - Phone
- (303) 429-4663
- NPI assigned
- Jun 2, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 21067 | CO | Primary |
Addresses
Primary practice location
1840 S Manor LN
Lakewood, CO 80232-7144
Mailing address
1840 S Manor LN
Lakewood, CO 80232-7144
Phone (303) 429-4663
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21067 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464825600000",
"number": "1073961710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 S MANOR LN",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802327144",
"telephone_number": "303-429-4663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 S MANOR LN",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802327144",
"telephone_number": "303-429-4663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUPP",
"first_name": "SUSAN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-02",
"last_updated": "2016-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "21067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.