Active NPI
Jordan Rudolph
- Health Educator
- Pittsboro, NC
National Provider Identifier
1740748698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 305980
- Practice address
- 47 S Parkside Dr
Pittsboro, NC 27312-6062 - Phone
- (479) 530-5761
- NPI assigned
- Mar 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 305980 | NC | |
| Health Educator | 174H00000X | 305980 | NC | Primary |
Addresses
Primary practice location
47 S Parkside Dr
Pittsboro, NC 27312-6062
Mailing address
47 S Parkside Dr
Pittsboro, NC 27312-6062
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
| License | State | Type | Specialty |
|---|---|---|---|
| 305980 | NC | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552262400000",
"number": "1740748698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 S PARKSIDE DR",
"city": "PITTSBORO",
"state": "NC",
"postal_code": "273126062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 S PARKSIDE DR",
"city": "PITTSBORO",
"state": "NC",
"postal_code": "273126062",
"telephone_number": "479-530-5761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOLPH",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-11",
"last_updated": "2019-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "305980",
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "NC",
"license": "305980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.