Active NPI
Rudolph Ivey Mintz, MD
- Gynecology Physician
- Kinston, NC
National Provider Identifier
1366495236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 15536
- Practice address
- 400 Glenwood Ave
Suite 11
Kinston, NC 28501 - Phone
- (252) 527-5500
- Fax
- (252) 527-4875
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 15536 | NC | Primary |
Addresses
Primary practice location
400 Glenwood Ave
Suite 11
Kinston, NC 28501
Mailing address
400 Glenwood Ave
Suite 11
Kinston, NC 28501
Phone (252) 527-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8953539 | Medicaid | NC |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1366495236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 GLENWOOD AVE",
"address_2": "SUITE 11",
"city": "KINSTON",
"state": "NC",
"postal_code": "28501",
"telephone_number": "252-527-5500",
"fax_number": "252-527-4875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 GLENWOOD AVE",
"address_2": "SUITE 11",
"city": "KINSTON",
"state": "NC",
"postal_code": "28501",
"telephone_number": "252-527-5500",
"fax_number": "252-527-4875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINTZ",
"first_name": "RUDOLPH",
"middle_name": "IVEY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "NC",
"license": "15536",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8953539",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kinston, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.