Ronald D Fudala, DC,DACAN

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

CH10979 Issued in FL

Practice address

1301 Plantation Island Dr S
Suite 402 a
Saint Augustine, FL 32080-3108

Phone

(904) 471-4744

Fax

(901) 471-4745

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Integrative Pain Solutions, PL

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • St Augustine, FL
  • NPI 1770504755
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1447362058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S",
            "address_2": "SUITE 402A",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320803108",
            "telephone_number": "904-471-4744",
            "fax_number": "904-471-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S",
            "address_2": "SUITE 402 A",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320803108",
            "telephone_number": "904-471-4744",
            "fax_number": "901-471-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUDALA",
        "first_name": "RONALD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC,DACAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "OH",
            "license": "1317",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH10979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000206217",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "44-00470",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2501109",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Friedman
• Susan Friedrich
• Friendly Faces Home and Companion Care
• Akinkawon Tahir Frierson, LABORATORY DIRECTOR
• Joann Fritsch
• Paul Fugelsang
• Full Bloom Chiropractic Corp
• Angelia Fuller, ARNP
• Antonia Fuller, A.R.N.P.
• Bryant Fuller, CRNA

• Neurology Chiropractor in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Neurology Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.