Active NPI
Gary Ray Rudolph
- Pharmacist
- Cocoa, FL
National Provider Identifier
1427499599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14618
- Practice address
- 7125 US 1
Cocoa, FL 32927 - Phone
- (321) 631-0300
- NPI assigned
- Jul 17, 2013
- Last updated
- Jul 17, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14618 | FL | Primary |
Addresses
Primary practice location
7125 US 1
Cocoa, FL 32927
Mailing address
7135 U.S. 1
Port St John, FL 32927
Phone (321) 631-0300
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14618 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hars Drugs Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374019200000",
"number": "1427499599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7135 U.S. 1",
"city": "PORT ST JOHN",
"state": "FL",
"postal_code": "32927",
"telephone_number": "321-631-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7125 US 1",
"city": "COCOA",
"state": "FL",
"postal_code": "32927",
"telephone_number": "321-631-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOLPH",
"first_name": "GARY",
"middle_name": "RAY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-17",
"last_updated": "2013-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "14618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cocoa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.