Sarah Michelle Rudder, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0000005219 Issued in TN

Practice address

1420 W Baddour Pkwy Ste 200
Lebanon, TN 37087-1510

Phone

(615) 444-4126

Fax

(855) 785-2890

NPI assigned

Jun 28, 2021

Last updated

Apr 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Botts Diabetes and EndocrinologyGroup PAC ID 5496094062, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IAGIAD

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.

• Botts Diabetes & Endocrinology

  • Family Nurse Practitioner
  • Lebanon, TN
  • NPI 1477044717
  Medicare reassignment Care Compare group
• Bradshaw Medical Clinic, PC

  • Clinic/Center
  • Lebanon, TN
  • NPI 1255406450
  NPD (past)
• Trevecca Nazarene University

  • Local Education Agency (LEA)
  • Nashville, TN
  • NPI 1033407952
  NPD (past)

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1669042230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 W BADDOUR PKWY STE 200",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370871510",
            "telephone_number": "615-444-4126",
            "fax_number": "855-785-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W BADDOUR PKWY STE 200",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370871510",
            "telephone_number": "615-444-4126",
            "fax_number": "855-785-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDER",
        "first_name": "SARAH",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000005219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan W Roundtree, M.D.
• Jordan Roundtree, APRN, PMHNP
• Tiffani Briana Roundtree
• Alivia Rowe, RBT
• Rox Dental Partners, PLLC (Davis Dentistry of Lebanon)
• Russell K Kirk, DDS, PC (Tennessee Implant & Oral Surgery)
• Michelle Sadler, LMT
• Sage Dental of Lebanon, PLLC
• Kellie O'Connell Sallis, ACNP-BC
• Kathryn Salsbury, RBT

• Physician Assistant in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.