NPIMap

Organization Active NPI

Rudisill Psychological Services LLC

  • Clinical Psychologist
  • Dayton, OH
National Provider Identifier
1326322439
Registry record updated Jan 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
RUDISILL PSYCHOLOGICAL SERVICES LLC
Practice address
1020 Woodman Dr
Ste 300
Dayton, OH 45432-1446
Phone
(937) 266-6914
Fax
(937) 434-8590
NPI assigned
Oct 7, 2011
Last updated
Jan 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2013

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

Authorized official

Name
Teresa RudisillNPI 1114928181
Title
Owner/Provider
Phone
(937) 266-6914

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

1020 Woodman Dr
Ste 300
Dayton, OH 45432-1446

Mailing address

1020 Woodman Dr
Ste 300
Dayton, OH 45432-1446
Phone (937) 266-6914

National Provider Directory

National Provider Directory

Locations

1020 Woodman Dr
Ste 300
Dayton, OH 45432
Phone (937) 253-0606

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359158400000",
    "number": "1326322439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 WOODMAN DR",
            "address_2": "STE 300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454321446",
            "telephone_number": "937-266-6914",
            "fax_number": "937-426-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 WOODMAN DR",
            "address_2": "STE 300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454321446",
            "telephone_number": "937-266-6914",
            "fax_number": "937-434-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUDISILL PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2013-01-26",
        "status": "A",
        "authorized_official_last_name": "RUDISILL",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "937-266-6914"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2013; 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.