Individual provider Active NPI

David Michael Rudd, MD

  • Emergency Medicine Physician
  • Jackson, MS
National Provider Identifier
1114458981
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
322837 Issued in LA
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 815-1292
Fax
(601) 984-5110
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 322837 LA Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

5246 Brittany Dr
Baton Rouge, LA 70808-9136
Phone (225) 757-4142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210108001319 LA Practitioner - Emergency Medicine 0547518201 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calcasieu Emergency Group LLCGroup PAC ID 4183651425, 25 clinicians

Practice addresses (Care Compare)

4200 Nelson Rd
Lake Charles, LA 70605-4118
Phone (337) 436-2511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.84 of 100Reported as group
Quality
82.42
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
322837LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Emergency Medicine Management -- Lake Charles LLC Emergency Medicine CurrentSince Feb 15, 2021 Accepting new patients
Vermilion Emergency Group LLC Emergency Medicine CurrentSince Dec 6, 2020 Accepting new patients

Locations

1310 W 7th St
Kaplan, LA 70548
Phone (318) 643-8300

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

Interoperability endpoints

  • Direct secure messaging: drudd400804@direct.ochsner.org

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1114458981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5246 BRITTANY DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089136",
            "telephone_number": "225-757-4142",
            "fax_number": "225-757-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-1292",
            "fax_number": "601-984-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "322837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.