Individual provider Active NPI

Richie Dudley, PARAMEDIC

  • Paramedic
  • Rockwall, TX
National Provider Identifier
1790399566
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ParamedicTaxonomy code 146L00000X
License
157780 Issued in TX
Practice address
931 W Yellowjacket LN Apt 805
Rockwall, TX 75087-4834
Phone
(469) 809-0520
NPI assigned
Aug 31, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ParamedicGroup: 193400000X SINGLE SPECIALTY GROUP 146L00000X 157780 TX Primary

Addresses

Primary practice location

931 W Yellowjacket LN Apt 805
Rockwall, TX 75087-4834

Mailing address

931 W Yellowjacket LN Apt 805
Rockwall, TX 75087-4834
Phone (469) 809-0520

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Rockwall

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
157780TXMDParamedic

NPI Registry JSON

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1790399566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 W YELLOWJACKET LN APT 805",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874834",
            "telephone_number": "469-809-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 W YELLOWJACKET LN APT 805",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874834",
            "telephone_number": "469-809-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "RICHIE",
        "credential": "PARAMEDIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "TX",
            "license": "157780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Rockwall",
            "affiliation": "N",
            "address_1": "931 W Yellowjacket Ln Apt 805",
            "city": "Rockwall",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750874834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.