Individual provider Active NPI

Nadia Rudenko, R.D.

  • Registered Dietitian
  • San Bernardino, CA
National Provider Identifier
1982908588
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1001281 Issued in CA
Practice address
361 W 44TH St
Apt 4
San Bernardino, CA 92407-3647
Phone
(909) 882-4425
NPI assigned
Dec 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1001281 CA Primary

Addresses

Primary practice location

361 W 44TH St
Apt 4
San Bernardino, CA 92407-3647

Mailing address

361 W 44TH St
Apt 4
San Bernardino, CA 92407-3647
Phone (909) 882-4425

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
1001281CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1982908588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 W 44TH ST",
            "address_2": "APT 4",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924073647",
            "telephone_number": "909-882-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 W 44TH ST",
            "address_2": "APT 4",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924073647",
            "telephone_number": "909-882-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDENKO",
        "first_name": "NADIA",
        "name_prefix": "Ms.",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-22",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1001281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.