Individual provider Active NPI

Dawn Marie Rudd, MD

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1669441937
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M5474 Issued in TX
Practice address
600 Division Ave Ste E
San Antonio, TX 78214-1336
Phone
(210) 364-9961
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M5474 TX Primary

Addresses

Primary practice location

600 Division Ave Ste E
San Antonio, TX 78214-1336

Mailing address

600 Division Ave Ste E
San Antonio, TX 78214-1336
Phone (210) 364-9961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20070606000460 TX Practitioner - Internal Medicine 6608974167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Pennsylvania State University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

600 Division Ave E
Wellmed at Division
San Antonio, TX 78214-1336
Phone (210) 222-0333

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M5474TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA Internal Medicine Current Accepting new patients
Wellmed Medical Group, PA Internal Medicine CurrentSince Apr 9, 2020 Accepting new patients
Wellmed Medical Group, P.a. Internal Medicine CurrentSince Apr 9, 2020 Accepting new patients
Dna Reference Lab Past Accepting new patients

Locations

7622 Louis Pasteur Dr
Ste 100
San Antonio, TX 78229
Phone (210) 614-7840

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

19500 Ih 10 W
Stop 24090
San Antonio, TX 78257
Phone (210) 762-3662

600 Division Ave
Ste E
San Antonio, TX 78214
Phone (210) 924-4279

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1669441937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 DIVISION AVE STE E",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782141336",
            "telephone_number": "210-364-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DIVISION AVE STE E",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782141336",
            "telephone_number": "210-364-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M5474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.