Samuel Washington Dudley III, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35079310 Issued in OH

Practice address

700 Children'S Drive
Columbus, OH 43205-2664

Phone

(614) 722-4554

Fax

(614) 722-4565

NPI assigned

Jun 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

HospitalistAlso: Pediatric Medicine

Education

Texas a & M University System, HSC, College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pediatric Academic Association, Inc.Group PAC ID 2961306774, 252 clinicians

Practice addresses (Care Compare)

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.

• Pediatric Academic Association, Inc.

  • Pediatrics Physician
  • Columbus, OH
  • NPI 1063419943
  Medicare reassignment Care Compare group NPD
• Nationwide Children'S Hospital

  • Multi-Specialty Clinic/Center
  • Columbus, OH
  • NPI 1851179873

  Pediatrics

  Medicare reassignment NPD
• Nationwide Children'S Hospital

  • Durable Medical Equipment & Medical Supplies
  • Columbus, OH
  • NPI 1447061262
  NPD
• Nationwide Children'S Hospital

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1134152986
  NPD (past)

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

{
    "created_epoch": "1119744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1669478459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDREN'S DRIVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000",
            "fax_number": "614-355-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDREN'S DRIVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-4554",
            "fax_number": "614-722-4565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 Butterly Gardens Drive",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432157508",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "SAMUEL",
        "middle_name": "WASHINGTON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-26",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "OH",
            "license": "35079310",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35079310",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35079310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0116931",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Norman Duderstadt Jr., LSW
• Anne Dudley-Marling, LPC
• Brianna Dudley
• Edward E Dudley Jr.
• Jennifer Dudley, CNP
• Sheena Dudley
• Sherean Dudley
• Walterina Anne Dudley
• Madison Dudon, MD
• Allison Kay Due

• Pediatrics Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.