Individual provider Active NPI

Lisa Rudd, NP

  • Women's Health Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1407273071
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
4704215073 Issued in MI
Practice address
3305 Spring Arbor Rd
Jackson, MI 49203-3794
Phone
(517) 768-4377
Fax
(517) 780-3932
NPI assigned
Mar 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4704215073 MI Primary

Addresses

Primary practice location

3305 Spring Arbor Rd
Jackson, MI 49203-3794

Mailing address

3305 Spring Arbor Rd
Jackson, MI 49203-3794
Phone (517) 768-4377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140407001774 MI Practitioner - Nurse Practitioner 0840422812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3305 Spring Arbor Rd
Suite 500
Jackson, MI 49203-3795
Phone (517) 205-3187

7845 Spring Arbor Rd
Spring Arbor, MI 49283-9785
Phone (517) 205-2580

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704215073MIMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Pathology Current Accepting new patients
Wa Foote Memorial Hospital, Inc Nurse Practitioner Current Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Apr 1, 2014 Accepting new patients
W.a. Foote Memorial Hospital, Inc Nurse Practitioner CurrentSince Apr 1, 2014 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

3305 Spring Arbor Rd
Ste 500
Jackson, MI 49203
Phone (517) 205-3187

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: lrudd453013@direct.hfhs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1407273071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 SPRING ARBOR RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033794",
            "telephone_number": "517-768-4377",
            "fax_number": "517-780-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 SPRING ARBOR RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033794",
            "telephone_number": "517-768-4377",
            "fax_number": "517-780-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "LISA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-21",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704215073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.