Individual provider Active NPI

Margaret M Rudin, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Avon, CT
National Provider Identifier
1275652851
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
003612 Issued in CT
Practice address
40 Avon Meadow LN # 203
Avon, CT 06001-3753
Phone
(860) 920-9720
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 003612 CT Primary

Addresses

Primary practice location

40 Avon Meadow LN # 203
Avon, CT 06001-3753

Mailing address

40 Avon Meadow LN # 203
Avon, CT 06001-3753
Phone (860) 920-9720

Other identifiers 1

IdentifierTypeStateIssuer
7272OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
003612CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center Past Accepting new patients
University of Connecticut Health Center 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1275652851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 AVON MEADOW LN # 203",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013753",
            "telephone_number": "860-920-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 AVON MEADOW LN # 203",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013753",
            "telephone_number": "860-920-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDIN",
        "first_name": "MARGARET",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "7272",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.