Timothy Rudolph MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TIMOTHY RUDOLPH MD PA

Practice address

400 N Brown St
Hamilton, TX 76531-1518

Phone

(254) 386-1600

Fax

(254) 386-4950

NPI assigned

Jun 11, 2019

Organization subpart

No

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

Authorized official

Name

Brenda L Hardin

Title

Ofc Ceo

Phone

(254) 223-0950

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy N Rudolph, M.D.

  • Family Medicine Physician
  • Hamilton, TX
  • NPI 1982777975
  Medicare reassignment NPD

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1932768264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 LEE RD",
            "city": "HAMILTON",
            "state": "TX",
            "postal_code": "765311700",
            "telephone_number": "254-223-0950",
            "fax_number": "972-722-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N BROWN ST",
            "city": "HAMILTON",
            "state": "TX",
            "postal_code": "765311518",
            "telephone_number": "254-386-1600",
            "fax_number": "254-386-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY RUDOLPH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFC CEO",
        "authorized_official_telephone_number": "254-223-0950"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199796703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Mitchell Smith
• Bailey Spradley
• Kristen L Stegemoller, M.D.
• Ping Ngi Tan, MD
• Breanna Templeton
• Grant Ward, PA-C
• Daniel Joseph Werlinger Sr., C.R.N.A.
• Amy M Williams
• George Daniel Williamson, MD
• Jerry W Zschiesche, D.D.S.

• Family Medicine Physician in Hamilton, TX
• Providers in Hamilton, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.