Active NPI
Rudolf Thomas Schmiedt I, MD
- Pediatrics Physician
- Evergreen, CO
National Provider Identifier
1376696013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 34411
- Practice address
- 30960 Stagecoach Blvd
Suite W-120
Evergreen, CO 80439-7902 - Phone
- (303) 674-6671
- Fax
- (303) 674-0031
- NPI assigned
- Jan 18, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 34411 | CO | Primary |
Addresses
Primary practice location
30960 Stagecoach Blvd
Suite W-120
Evergreen, CO 80439-7902
Mailing address
30960 Stagecoach Blvd
Suite W-120
Evergreen, CO 80439-7902
Phone (303) 674-6671
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40308332 | Medicaid | CO |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34411 | CO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evergreen Pediatrics, LLC | Pediatrics | Past | Accepting new patients |
| Conifer Pediatrics | Pediatrics | Past | Accepting new patients |
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.
-
- Pediatrics Physician
- Conifer, CO
- NPI 1265929814
-
- Pediatrics Physician
- Evergreen, CO
- NPI 1689839144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524009600000",
"number": "1376696013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30960 STAGECOACH BLVD",
"address_2": "SUITE W-120",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "804397902",
"telephone_number": "303-674-6671",
"fax_number": "303-674-0031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30960 STAGECOACH BLVD",
"address_2": "SUITE W-120",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "804397902",
"telephone_number": "303-674-6671",
"fax_number": "303-674-0031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHMIEDT",
"first_name": "RUDOLF",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"name_suffix": "I",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2018-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CO",
"license": "34411",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40308332",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evergreen, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.