Active NPI
Ron J Rudometkin, DC
- Chiropractor
- Sacramento, CA
National Provider Identifier
1245283159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC21109
- Practice address
- 5120 J Street
Suite C
Sacramento, CA 95819 - Phone
- (916) 733-0655
- Fax
- (916) 733-0650
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC21109 | CA | Primary |
Addresses
Primary practice location
5120 J Street
Suite C
Sacramento, CA 95819
Mailing address
5120 J Street
Suite C
Sacramento, CA 95819
Phone (916) 733-0655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051024001161 | CA | Practitioner - Chiropractic | 4981621406 | Practice locations: Sacramento, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC21109 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1245283159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5120 J STREET",
"address_2": "SUITE C",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95819",
"telephone_number": "916-733-0655",
"fax_number": "916-733-0650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5120 J STREET",
"address_2": "SUITE C",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95819",
"telephone_number": "916-733-0655",
"fax_number": "916-733-0650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOMETKIN",
"first_name": "RON",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC21109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.