Individual provider Active NPI

Steven R Rudman, DPM

  • Foot & Ankle Surgery Podiatrist
  • Manchester, NH
National Provider Identifier
1720170368
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0139 Issued in NH
Practice address
424 Hanover Street
Manchester, NH 03104
Phone
(603) 668-3509
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0139 NH Primary

Addresses

Primary practice location

424 Hanover Street
Manchester, NH 03104

Mailing address

424 Hanover Street
Manchester, NH 03104
Phone (603) 668-3509

Other identifiers 3

IdentifierTypeStateIssuer
333798OtherHARVARD PILGRIM
709414OtherTUFTS
030824640NH04OtherNHANTHEM BCBS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
139NHMDMental Health Counselor
0139NHMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1720170368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 HANOVER STREET",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03104",
            "telephone_number": "603-668-3509",
            "fax_number": "603-641-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 HANOVER STREET",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03104",
            "telephone_number": "603-668-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDMAN",
        "first_name": "STEVEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NH",
            "license": "0139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "333798",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "709414",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "030824640NH04",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.