Active NPI
John Anthony Rudis, M.D.
- Family Medicine Physician
- Lufkin, TX
National Provider Identifier
1346221173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- H2745
- Practice address
- 206 Gene Samford Dr
Suite a
Lufkin, TX 75904-3374 - Phone
- (936) 637-7667
- Fax
- (936) 637-2363
- NPI assigned
- Nov 9, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H2745 | TX | Primary |
Addresses
Primary practice location
206 Gene Samford Dr
Suite a
Lufkin, TX 75904-3374
Mailing address
206 Gene Samford Dr
Suite a
Lufkin, TX 75904-3374
Phone (936) 637-7667
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120513003 | Medicaid | TX | |
| 120513004 | Medicaid | TX |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H2745 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epilepsy Foundation of Texas | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1346221173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 GENE SAMFORD DR",
"address_2": "SUITE A",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043374",
"telephone_number": "936-637-7667",
"fax_number": "936-637-2363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 GENE SAMFORD DR",
"address_2": "SUITE A",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043374",
"telephone_number": "936-637-7667",
"fax_number": "936-637-2363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDIS",
"first_name": "JOHN",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-09",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "H2745",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120513003",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120513004",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lufkin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.