Individual provider Active NPI

Susan Faith Rudy, MSN, FNP-BC, CORLN

  • Family Nurse Practitioner
  • Bethesda, MD
National Provider Identifier
1386893295
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP084977 Issued in MD
Practice address
10 Center Drive
Building 10 Room 5C409
Bethesda, MD 20892
Phone
(301) 496-4887
Fax
(301) 451-5404
NPI assigned
Sep 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 NP084977 MD Primary

Addresses

Primary practice location

10 Center Drive
Building 10 Room 5C409
Bethesda, MD 20892

Mailing address

10 Center Drive
Building 10 Room 5C409
Bethesda, MD 20892
Phone (301) 496-4887

Other identifiers 2

IdentifierTypeStateIssuer
R084977OtherMDMARYLAND BOARD OF NURSING
N36082OtherMDSTATE OF MD DEPT OF HEALTH AND MENTAL HYGIENE, DIVISION OF DRUG CONTROL

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
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
NP084977MDMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1386893295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CENTER DRIVE",
            "address_2": "BUILDING 10 ROOM 5C409",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20892",
            "telephone_number": "301-496-4887",
            "fax_number": "301-451-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CENTER DRIVE",
            "address_2": "BUILDING 10 ROOM 5C409",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20892",
            "telephone_number": "301-496-4887",
            "fax_number": "301-451-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDY",
        "first_name": "SUSAN",
        "middle_name": "FAITH",
        "name_prefix": "Ms.",
        "credential": "MSN, FNP-BC, CORLN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "NP084977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD OF NURSING",
            "identifier": "R084977",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MD DEPT OF HEALTH AND MENTAL HYGIENE, DIVISION OF DRUG CONTROL",
            "identifier": "N36082",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.