Beth Conrad Rupp, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01062309A Issued in IN

Practice address

600 N Jordan Ave
Bloomington, IN 47405-3190

Phone

(812) 855-0093

NPI assigned

Feb 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1972576080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N JORDAN AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474053190",
            "telephone_number": "812-855-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N JORDAN AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474053190",
            "telephone_number": "812-855-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPP",
        "first_name": "BETH",
        "middle_name": "CONRAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00043577",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01062309A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8406910",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Ruiz, M.D.
• Elizabeth Rumley, RBT
• Bridget Rund, NP
• Matthew David Runnebohm, M.D.
• Alyah Rupley, RBT
• William Parker Rusche, M.D.
• Laurie Rushlow, PSY.D.
• Michelle Rushton Perry, MSW
• Brandy Russell-Mervosh, LCSW
• Brittany Russell

• Family Medicine Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.