Active NPI
Norman Eric Rudolph, MD
- Internal Medicine Physician
- Middletown, RI
National Provider Identifier
1568523629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD04177
- Practice address
- 333 Valley Rd
Middletown, RI 02842-7230 - Phone
- (401) 849-3925
- Fax
- (401) 849-3929
- NPI assigned
- Dec 13, 2006
- Last updated
- Nov 13, 2007
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD04177 | RI | Primary |
Addresses
Primary practice location
333 Valley Rd
Middletown, RI 02842-7230
Mailing address
333 Valley Rd
Middletown, RI 02842-7230
Phone (401) 849-3925
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001953 | Other | RI | BLUE CHIP |
| 0124162 | Other | SECURE HORIZONS | |
| 9002323 | Medicaid | RI | |
| 0555996 | Other | AETNA | |
| 23232 | Other | RI | RIBC |
| 0400135 | Other | UNITED HEALTH |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD04177 | RI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194912000000",
"number": "1568523629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 VALLEY RD",
"city": "MIDDLETOWN",
"state": "RI",
"postal_code": "028427230",
"telephone_number": "401-849-3925",
"fax_number": "401-849-3929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 VALLEY RD",
"city": "MIDDLETOWN",
"state": "RI",
"postal_code": "028427230",
"telephone_number": "401-849-3925",
"fax_number": "401-849-3929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOLPH",
"first_name": "NORMAN",
"middle_name": "ERIC",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2007-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "MD04177",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "001953",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECURE HORIZONS",
"identifier": "0124162",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9002323",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0555996",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RIBC",
"identifier": "23232",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH",
"identifier": "0400135",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Middletown, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.