Active NPI
Heather Rudalavage, RD, LDN
- Registered Dietitian
- Fort Washington, PA
National Provider Identifier
1265734917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN004094
- Practice address
- 1023 Hawthorne LN
Fort Washington, PA 19034-1736 - Phone
- (215) 643-3572
- NPI assigned
- Dec 1, 2010
- Last updated
- Feb 1, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN004094 | PA | Primary |
Addresses
Primary practice location
1023 Hawthorne LN
Fort Washington, PA 19034-1736
Mailing address
1023 Hawthorne LN
Fort Washington, PA 19034-1736
Phone (215) 696-3238
Other practice location 1
8380 Old York Rd Ste 100
Elkins Park, PA 19027-1574
Phone (215) 517-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265734917 | Other | PA | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN004094 | PA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heather Rudalavage Rd LDN | Dietitian, Registered | Past | Accepting new patients |
| Nutrition 4 Family, LLC | Dietitian, Registered | Past | Accepting new patients |
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.
-
dba Intuitive Nutrition
- Registered Dietitian
- Fort Washington, PA
- NPI 1740566751
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548979200000",
"number": "1265734917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1023 HAWTHORNE LN",
"city": "FORT WASHINGTON",
"state": "PA",
"postal_code": "190341736",
"telephone_number": "215-696-3238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1023 HAWTHORNE LN",
"city": "FORT WASHINGTON",
"state": "PA",
"postal_code": "190341736",
"telephone_number": "215-643-3572"
}
],
"practiceLocations": [
{
"address_1": "8380 Old York Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Elkins Park",
"state": "PA",
"postal_code": "190271574",
"country_code": "US",
"telephone_number": "215-517-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUDALAVAGE",
"first_name": "HEATHER",
"credential": "RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-01",
"last_updated": "2019-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN004094",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1265734917",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Washington, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.