Individual provider Active NPI

James H Rudick, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Canton, OH
National Provider Identifier
1417062928
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
35041307 Issued in OH
Practice address
4765 Higbee Ave NW
Ste B
Canton, OH 44718-2551
Phone
(330) 492-2266
Fax
(330) 492-2216
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35041307 OH
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 35041307 OH Primary

Addresses

Primary practice location

4765 Higbee Ave NW
Ste B
Canton, OH 44718-2551

Mailing address

PO Box 80690
Canton, OH 44708
Phone (330) 833-5530

Other identifiers 1

IdentifierTypeStateIssuer
0405832MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070216000343 OH Practitioner - Endocrinology 5597867812 Practice locations: Canton, OH

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Cincinnati College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4765 Higbee Ave NW
Canton, OH 44718-2551
Phone (330) 492-2266

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Hospital & facility affiliations 3

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1417062928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80690",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44708",
            "telephone_number": "330-833-5530",
            "fax_number": "330-833-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 HIGBEE AVE NW",
            "address_2": "STE B",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182551",
            "telephone_number": "330-492-2266",
            "fax_number": "330-492-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDICK",
        "first_name": "JAMES",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35041307",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OH",
            "license": "35041307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0405832",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.