Paul Rudd, REG DIETICIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

KY1534 Issued in KY

Practice address

307 E 12TH St
Benton, KY 42025

Phone

(270) 527-1496

Fax

(270) 527-5321

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marshall County Health DeptGroup PAC ID 8527000314, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marshall County Health Dept

  • Public Health or Welfare Agency
  • Benton, KY
  • NPI 1104800127
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1831241611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 SLICKBACK RD",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420257629",
            "telephone_number": "270-527-1496",
            "fax_number": "270-252-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E 12TH ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "42025",
            "telephone_number": "270-527-1496",
            "fax_number": "270-527-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "REG DIETICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "KY1534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20079018",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendra Connell Riley
• Rma - Operating, Inc.
• Rma-Operating, Inc.
• Jan C Roberson, LPCC
• Jeana Lee Rodgers, DC
• Sidney Avan Rudd, PT, DPT
• Claude E Saint-Jacques, MD
• Kayle Sanders, RN, SANE
• Samantha Ann Scholl, MSN, APRN, FNP-C
• Jerry Cendell Sells, D.M.D

• Registered Dietitian in Benton, KY
• Providers in Benton, KY by specialty
• Registered Dietitian in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.