Individual provider Active NPI

Lori Ann Rudker, RPH

  • Pharmacist
  • Norwich, CT
National Provider Identifier
1912417718
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5942 Issued in CT
Practice address
224 Salem Tpke
Norwich, CT 06360-6455
Phone
(860) 886-1301
Fax
(860) 886-1304
NPI assigned
Oct 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5942 CT Primary

Addresses

Primary practice location

224 Salem Tpke
Norwich, CT 06360-6455

Mailing address

224 Salem Tpke
Norwich, CT 06360-6455
Phone (860) 886-1301

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5942CTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Big Y Foods, Inc Past Accepting new patients
Big Y Foods Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1912417718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 SALEM TPKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063606455",
            "telephone_number": "860-886-1301",
            "fax_number": "860-886-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 SALEM TPKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063606455",
            "telephone_number": "860-886-1301",
            "fax_number": "860-886-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDKER",
        "first_name": "LORI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-05",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "5942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; 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.