Individual provider Active NPI

Marcia Ellen Rudnick

  • Speech-Language Pathologist
  • Wernersville, PA
National Provider Identifier
1407230568
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL000221L Issued in PA
Practice address
One Heidelberg Drive
Wernersville, PA 19565
Phone
(610) 927-8160
NPI assigned
Jul 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL000221L PA Primary

Addresses

Primary practice location

One Heidelberg Drive
Wernersville, PA 19565

Mailing address

One Heidelberg Drive
Wernersville, PA 19565
Phone (610) 927-8160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151027002892 PA Practitioner - Qualified Speech Language Pathologist 8224347570 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SL000221LPAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Corporate and Community Based Services Inc CurrentSince Aug 1, 2015 Accepting new patients
Phoebe Corporate & Community Based Services CurrentSince Aug 1, 2015 Accepting new patients

Locations

1925 W Turner St
Allentown, PA 18104
Phone (610) 794-5075

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": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1407230568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE HEIDELBERG DRIVE",
            "city": "WERNERSVILLE",
            "state": "PA",
            "postal_code": "19565",
            "telephone_number": "610-927-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HEIDELBERG DRIVE",
            "city": "WERNERSVILLE",
            "state": "PA",
            "postal_code": "19565",
            "telephone_number": "610-927-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDNICK",
        "first_name": "MARCIA",
        "middle_name": "ELLEN",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL000221L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wernersville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.