Rudolph Jeffries Jr., MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

D39590 Issued in MD

Practice address

301 Hospital Dr
Glen Burnie, MD 21061-5803

Phone

(410) 787-4565

Fax

(410) 766-7602

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Baltimore Washington Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Glen Burnie, MD
  • NPI 1215983853
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1447293964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 AMHERST AVE",
            "address_2": "STE 102",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209024665",
            "telephone_number": "301-933-7827",
            "fax_number": "240-290-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-787-4565",
            "fax_number": "410-766-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "RUDOLPH",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D39590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075031000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madhu Sreekanth Jasti, M.D
• Elnaz Javadkhani, DDS
• Thirumalairaj Jeevan, M.D.
• Jeffrey L Bober DPM PA
• Jeffrey L Bober, DPM PA
• Megan Lauren Jendrossek, CRNP
• Brittany Jo Jenkins, PA-C
• Jennifer Stewart DDS LLC (Glen Burnie Family Dental)
• Christen Margaret Jeter
• Mandi Jewer, RN

• Emergency Medicine Physician in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Emergency Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.