Individual provider Active NPI

Emilianne Rudd, NP

  • Nurse Practitioner
  • Carlsbad, CA
National Provider Identifier
1174261945
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95020133 Issued in CA
Practice address
1056 Sagebrush Rd
Carlsbad, CA 92011-3974
Phone
(248) 202-8997
NPI assigned
May 23, 2022
Last updated
May 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95020133 CA Primary

Addresses

Primary practice location

1056 Sagebrush Rd
Carlsbad, CA 92011-3974

Mailing address

1056 Sagebrush Rd
Carlsbad, CA 92011-3974
Phone (248) 202-8997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230112002748 CA Practitioner - Nurse Practitioner 2567848732 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95020133CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Jolla Spine Institute Medical Group, Inc. CurrentSince Oct 18, 2022 Accepting new patients
San Dieguito Orthopedic Medical Center P C CurrentSince Oct 18, 2022 Accepting new patients

Locations

332 Santa Fe Dr
Ste 110
Encinitas, CA 92024
Phone (760) 632-4266

332 Santa Fe Dr
Ste 120
Encinitas, CA 92024
Phone (760) 942-4400

Organizations & group practices 2

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": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1174261945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1056 SAGEBRUSH RD",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920113974",
            "telephone_number": "248-202-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 SAGEBRUSH RD",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920113974",
            "telephone_number": "248-202-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "EMILIANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95020133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.