Randal Rudderman, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

024863 Issued in GA

Practice address

3400-C Old Milton Pkwy,
Ste 450
Alpharetta, GA 30005-3707

Phone

(678) 566-7200

Fax

(678) 566-7210

NPI assigned

Oct 3, 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

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1639263676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400-C OLD MILTON PKWY,",
            "address_2": "STE 450",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053707",
            "telephone_number": "678-566-7200",
            "fax_number": "678-566-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400-C OLD MILTON PKWY,",
            "address_2": "STE 450",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053707",
            "telephone_number": "678-566-7200",
            "fax_number": "678-566-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDERMAN",
        "first_name": "RANDAL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "024863",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "GA",
            "license": "024863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RS Goldring Inc
• RS Goldring Inc
• RSS Gary Nelson LLC
• Rebecca Caroline Rubadou, P.T., D.P.T
• David M. Ruben, M.D.
• Sarah Rudnicki
• Emily Ruggles, APC, CRC
• Lauren Runner, DC
• Angelica Russell
• Emily Russell

• Plastic and Reconstructive Surgery Physician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Plastic and Reconstructive Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.