Individual provider Active NPI

Matthew C Ludgood, LPN

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1689346488
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
341652 Issued in NY
Practice address
1630 Dewey Ave Apt 216
Rochester, NY 14615-3447
Phone
(585) 729-6895
NPI assigned
Sep 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 341652 NY Primary

Addresses

Primary practice location

1630 Dewey Ave Apt 216
Rochester, NY 14615-3447

Mailing address

1630 Dewey Ave Apt 216
Rochester, NY 14615-3447
Phone (585) 729-6895

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

State licenses

LicenseStateTypeSpecialty
341652NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1689346488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 DEWEY AVE APT 216",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146153447",
            "telephone_number": "585-729-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 DEWEY AVE APT 216",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146153447",
            "telephone_number": "585-729-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDGOOD",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "341652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.