NPIMap

Organization Active NPI

James R. Rudd Sr., M.D., LLC

  • Medical Specialty Clinic/Center
  • Deridder, LA
National Provider Identifier
1114223898
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
15081 Issued in LA
Legal business name
JAMES R. RUDD SR., M.D., LLC
Practice address
206 W 5TH St
Deridder, LA 70634-4856
Phone
(337) 463-5582
Fax
(337) 460-1348
NPI assigned
Jan 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Authorized official

Name
Dr. James R. Rudd Sr., MD
Title
Physician
Phone
(337) 463-5582

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 15081 LA Primary

Addresses

Primary practice location

206 W 5TH St
Deridder, LA 70634-4856

Mailing address

206 W 5TH St
Deridder, LA 70634-4856
Phone (337) 463-5582

Other identifiers 1

IdentifierTypeStateIssuer
1329754MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1114223898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W 5TH ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344856",
            "telephone_number": "337-463-5582",
            "fax_number": "337-460-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W 5TH ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344856",
            "telephone_number": "337-463-5582",
            "fax_number": "337-460-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES R. RUDD SR., M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "RUDD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "337-463-5582",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "LA",
            "license": "15081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1329754",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.