Individual provider Active NPI

Ann Theresa Rudat, AUD

  • Audiologist
  • Fort Polk, LA
National Provider Identifier
1750445508
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT001159-L Issued in PA
Practice address
1585 3Rd St Bjach
Eent Clinic
Ft. Polk, LA 71459
Phone
(337) 531-3297
Fax
(337) 531-3290
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT001159-L PA Primary

Addresses

Primary practice location

1585 3Rd St Bjach
Eent Clinic
Ft. Polk, LA 71459

Mailing address

7572 Kurthwood Rd
Leesville, LA 71446

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
AT001159-LPAMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750445508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7572 KURTHWOOD RD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "71446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 3RD ST BJACH",
            "address_2": "EENT CLINIC",
            "city": "FT. POLK",
            "state": "LA",
            "postal_code": "71459",
            "telephone_number": "337-531-3297",
            "fax_number": "337-531-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDAT",
        "first_name": "ANN",
        "middle_name": "THERESA",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT001159-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Polk, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.