Rudy Hartono Taarea, MD

Primary specialty

Aerospace Medicine PhysicianTaxonomy code 2083A0100X

License

AL19483 Issued in AL

Practice address

511 Brantley St
Opp, AL 36467-1702

Phone

(334) 493-3240

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rudy.taarea.1@9069.direct.athenahealth.com

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.

• Franklin Primary Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
  • NPI 1679532303
  Medicare reassignment NPD
• Vincentian Physician Services LLC

  • Family Medicine Physician
  • Birmingham, AL
  • NPI 1851698310
  Medicare reassignment NPD
• Franklin Primary Health Center, Inc

  dba Franklin Evergreen Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Evergreen, AL
  • NPI 1346733821
  NPD
• Franklin Primary Health Center, Inc

  dba Uriah Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Uriah, AL
  • NPI 1881014371
  NPD

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1336121862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 BRANTLEY ST",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364671702",
            "telephone_number": "334-493-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 BRANTLEY ST",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364671702",
            "telephone_number": "334-493-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAAREA",
        "first_name": "RUDY",
        "middle_name": "HARTONO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "AL",
            "license": "AL19483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Stinson
• Charles Loftin Studstill Jr., PHARMD
• Stormie Suhre
• Sycamore Physicians LLC
• T & C Pharmacy Inc (T and C Pharmacy, Inc.)
• Janice Alangwawi Tabios, PT
• Veronica Tate
• Teki Hegwood MD PC (Opptimal Women's Health)
• Savannah Thompson
• Robin Lashon Tillman, MCD,CCC-SLP

• Aerospace Medicine Physician in Opp, AL
• Providers in Opp, AL by specialty
• Aerospace Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.