Carla Rudolph, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A-1770-13 Issued in NM

Practice address

1851 Old US 66
Edgewood, NM 87015-7200

Phone

(505) 286-2396

NPI assigned

Apr 2, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, MD, DC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• American Current Care PA

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1003090879

  DC

  Medicare reassignment NPD
• American Current Care PA

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1235313156

  MD

  Medicare reassignment NPD
• DLP Person Urgent Care LLC

  • Urgent Care Clinic/Center
  • Roxboro, NC
  • NPI 1275043481
  Medicare reassignment NPD
• American Current Care, PA.

  • Urgent Care Clinic/Center
  • Alexandria, VA
  • NPI 1477736528
  NPD
• DLP Person Urgent Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Chapel Hill, NC
  • NPI 1417460940
  NPD
• Lovelace Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Albuquerque, NM
  • NPI 1932911351
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1104182328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 OLD US 66",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870157200",
            "telephone_number": "505-286-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 OLD US 66",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870157200",
            "telephone_number": "505-286-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "CARLA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NM",
            "license": "A-1770-13",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104182328",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Romans, DPT
• Mary Ann B Romero, PHYSICAL THERAPIST
• Julian F Rowe, MD
• Reid Rowe, RPH
• Doreen Eleanor Rudman, PT
• Matthew Paul Sanchez, MOTR/L
• Melynda D Sanchez
• Sidney Sanchez
• Sandia Mountain Medical, Inc.
• Sandia Mountain Medical, Inc.

• General Practice Physician in Edgewood, NM
• Providers in Edgewood, NM by specialty
• General Practice Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.

Verify at the official NPI Registry.