Individual provider Active NPI

Rude N Henry

  • Family Nurse Practitioner
  • Lauderdale Lakes, FL
National Provider Identifier
1346867090
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11004115 Issued in FL
Practice address
2331 N State Road 7 Ste 206
Lauderdale Lakes, FL 33313-3772
Phone
(954) 677-0393
NPI assigned
Jun 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11004115 FL Primary

Addresses

Primary practice location

2331 N State Road 7 Ste 206
Lauderdale Lakes, FL 33313-3772

Mailing address

5713 NW 74TH Ave
Tamarac, FL 33321-6013
Phone (954) 213-2460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220815001160 FL Practitioner - Nurse Practitioner 1153704739 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11004115FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Satya P Singh MD PA CurrentSince Apr 28, 2022 Accepting new patients
Eb Land Investment LLC PastSince Jul 5, 2020 Accepting new patients

Locations

1625 SE 3rd Ave
Ste 715
Ft Lauderdale, FL 33316
Phone (954) 217-8866

300 NW 70th Ave
Ste 205
Plantation, FL 33317
Phone (954) 321-5428

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": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1346867090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5713 NW 74TH AVE",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333216013",
            "telephone_number": "954-213-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 N STATE ROAD 7 STE 206",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333133772",
            "telephone_number": "954-677-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "RUDE",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.