RUDY MARTIN TEDJA (NPI# 1639344963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639344963 |
| Entity Type | Individual |
| Full Name | RUDY MARTIN TEDJA |
| Credential | DO |
| Practice Address |
1155 Mill St Reno NV 89502 |
| Mailing Address |
850 Harvard Way Reno NV 89502-2055 |
| Practice Telephone | 7759827878 |
| Practice Fax Number | 7759824196 |
| Mailing Telephone | 7759825262 |
| Mailing Fax Number | 7759825496 |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2018-09-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
DO2441 | NV | Allopathic & Osteopathic Physicians |
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
20A13497 | CA | Allopathic & Osteopathic Physicians |
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
57113 | MN | Allopathic & Osteopathic Physicians |
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
DO2441 | NV | Allopathic & Osteopathic Physicians |
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
34.009823 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CAQH | 14271792 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10101 Double R Blvd, Reno, NV 895213149 | 7759827878 | 7759824196 |
| 600 Coffee Rd, Modesto, CA 953554201 | 2095216097 |
| Street Address |
1155 MILL ST |
| City | RENO |
| State | NV |
| Zip Code | 89502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405456 | Phyllis Joyce Ager | Radiology | 1155 Mill St, Mail Code L11, Reno, NV 89502-1576 | 2005-05-27 |
| 1245830405 | Melissa Kimberly Herrera | Technician | 1155 Mill St, Reno, NV 89502-1576 | 2020-10-27 |
| 1386250298 | Corinne Elizabeth Canavero | Nurse Practitioner | 1155 Mill St, Reno, NV 89502-1576 | 2020-09-17 |
| 1457969479 | Cory Lankford | Pharmacist | 1155 Mill St, Reno, NV 89502-1576 | 2020-07-15 |
| 1710500947 | Dana Robinson | Occupational Therapist | 1155 Mill St, Reno, NV 89502-1576 | 2020-05-21 |
| 1376162495 | Erin Miranda Madsen | Registered Nurse | 1155 Mill St, Reno, NV 89502-1576 | 2020-04-09 |
| 1568092336 | Jodi Danielson | Home Health | 1155 Mill St, Reno, NV 89502-1576 | 2020-01-21 |
| 1184266298 | Janeen Lou Ibarreta | Pharmacist | 1155 Mill St, Reno, NV 89502-1576 | 2019-10-09 |
| 1558914465 | Jasmine Ghuman | Student in an Organized Health Care Education/Training Program | 1155 Mill St, Reno, NV 89502-1576 | 2019-07-19 |
| 1205498987 | Unr | Clinic/Center | 1155 Mill St, Reno, NV 89502-1576 | 2019-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314264 | State of Nevada | Community/Behavioral Health | 4600 Kietzke Lane Bldg D, Reno, NV 89502 | 2020-07-23 |
| 1447879259 | Ryan Johnson | Student in an Organized Health Care Education/Training Program | 1155 Mill St. W-11, Reno, NV 89502 | 2020-04-11 |
| 1396378063 | Domingko Loney | Chore Provider | 1325 Air Motive Wat St 262, Reno, NV 89502 | 2020-02-20 |
| 1053954842 | Derek Craig | Home Health Aide | 1000 Havard Way #29, Reno, NV 89502 | 2019-10-24 |
| 1477108124 | Marisa Rachael Traversie | Nurse Practitioner | 910 Vista Boulevard, Sparks, NV 89502 | 2019-08-08 |
| 1912564675 | Patrick Llewellyn Merrill | Social Worker | 975 Kirman Ave - Ch 116, Reno, NV 89502 | 2019-05-28 |
| 1881154706 | Naresh Kumar Veerabattini | Student in an Organized Health Care Education/Training Program | 1155 Mill St, Renown Regional Medical Center, W11 Academic Department Offices, Reno, NV 89502 | 2019-03-25 |
| 1053899187 | Daphne London | Behavioral Analyst | 1325 Airmotive Way Ste 260, Reno, NV 89502 | 2018-07-31 |
| 1790271609 | Jennifer J Padolina | Optometrist | 2296 Kietzke Ln, Reno, NV 89502 | 2018-07-03 |
| 1336630185 | Lindsey Cherie Cooper | Technician | 3563 Sol Grande Ct, Reno, NV 89502 | 2018-05-27 |
| Find all providers in zip 89502 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376526822 | John Douglas Andrews Jr. | Internal Medicine | 990 Caughlin Xing Bldg A, Reno, NV 89519-0631 | 2005-11-29 |
| 1538424239 | Saint Marys Medical Group Inc. | Internal Medicine | 411 W 6th St, Reno, NV 89503-4415 | 2012-07-09 |
| 1952668105 | William Barker Graham IIi | Internal Medicine | 236 W 6th St Ste 200, Reno, NV 89503-4550 | 2012-04-12 |
| 1083903678 | Faisal M. Siddiqui | Internal Medicine | 1000 Locust St, Dept. of Internal Medicine, Reno, NV 89502-2597 | 2011-04-04 |
| 1255655023 | Jose A Aguirre Md PC Reno | Internal Medicine | 235 W 6th St, Reno, NV 89503-4548 | 2010-03-22 |
| 1629275581 | Joshua F Jewell | Internal Medicine | 1155 Mill St, Reno, NV 89502-1576 | 2007-07-02 |
| 1366450033 | Michael P Young | Internal Medicine | 1155 Mill St, Reno, NV 89502 | 2006-08-04 |
| 1770506214 | Christopher Paul Nielson | Internal Medicine | 1000 Locust St, Reno, NV 89502-2597 | 2006-07-25 |
| 1093731572 | Nitinkumar Bhatt | Internal Medicine | 1000 Locust St, Reno, NV 89502-2597 | 2006-07-15 |
| 1235117672 | Robert Burke Richeson IIi | Internal Medicine | 1155 Mill St, Reno, NV 89502 | 2006-01-05 |
| Find all providers in RENO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.