DAVID SAMUEL RUDOLPH (NPI# 1881836013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881836013 |
| Entity Type | Individual |
| Full Name | DAVID SAMUEL RUDOLPH |
| Credential | D.O. |
| Practice Address |
354 Newnan Crossing Byp Suite 205 Newnan GA 30265-2323 |
| Mailing Address |
95 Collier Rd Nw Suite 4075 Atlanta GA 30309-1796 |
| Practice Telephone | 6783264812 |
| Mailing Telephone | 4043553200 |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2014-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | OS014560 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | MLHC GROUP AA # | 037276 | 01 |
| PA | MLHC MEDICARE AA# | 440771 | 01 |
| PA | MLHC GROUP NPI # | 1922077643 | 01 |
| PA MEDICAL LICENSE # | OS14560 | 01 | |
| PA | BS AA# | 824305 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982794418 | David Jeffrey Rudolph | Dentist | 9453 Gierson Ave, Chatsworth, CA 91311-4705 | 2006-10-13 |
| 1376526749 | David Scott Rudolph | Internal Medicine | 561 S Denali, Ste C, Palmer, AK 99645 | 2005-11-21 |
| 1619504776 | David Rudolph | Student in an Organized Health Care Education/Training Program | 1830 E Monument St Ste 6-100, Baltimore, MD 21287-0020 | 2020-03-26 |
| 1255854543 | David Richard Rudolph | Nurse Practitioner | 6236 E Pima St Ste 100, Tucson, AZ 85712-3164 | 2017-07-19 |
| 1821119108 | David Howard Rudolph | Optometrist | 206 Willow Dr, Levittown, PA 19054-3121 | 2007-04-03 |
| 1912939034 | David B Rudolph | Otolaryngology | 825 Main St, Weymouth, MA 02190-1659 | 2006-07-07 |
| Street Address |
354 NEWNAN CROSSING BYP SUITE 205 |
| City | NEWNAN |
| State | GA |
| Zip Code | 30265-2323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528034121 | Jennifer Tinsley Maninger | Occupational Therapist | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2006-02-24 |
| 1679015598 | Kharisma Marie Huggins | Nurse Practitioner | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2016-11-09 |
| 1750730123 | Shorrod Mcclain | Physician Assistant | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2016-06-07 |
| 1386023901 | Orthoatlanta | Orthopaedic Surgery | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2015-05-28 |
| 1356784599 | Jo Ann Woodie | Nurse Practitioner | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2013-04-08 |
| 1275883951 | Timothy Heath Blackmon | Specialist/Technologist | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2012-09-11 |
| 1902151012 | Melinda Emery Jennings | Nurse Practitioner | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2012-07-16 |
| 1386946598 | Orthoatlanta, LLC | Orthopaedic Surgery | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2010-11-19 |
| 1780812875 | Mario Fernando Cruz Alzate | Physical Therapist | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2009-06-26 |
| 1003089061 | Gordon B Harrison II | Physical Therapist | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2008-04-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265041537 | Shiva Bazargan | Pharmacist | 3116 Sr 34 West, Newnan, GA 30265 | 2020-07-23 |
| 1992322549 | Doctorsbeyond Inc. | Clinic/Center | 277 Skyview Court, Newnan, GA 30265 | 2020-06-30 |
| 1225652936 | Jerrica Conyers | Nurse Practitioner | 1635 Highwat 34 East Suite C, Newnan, GA 30265 | 2020-05-29 |
| 1982234688 | Morgan Elizabeth Bross | Physician Assistant | 1825 Ga- 34, Newnan, GA 30265 | 2020-01-22 |
| 1013553379 | Hopebridge LLC | Behavior Technician | 2147 Newnan Crossing Boulevard East, Newnan, GA 30265 | 2019-11-21 |
| 1518528116 | Stepping Stones Psychiatric Care LLC | Nurse Practitioner | 3025 Sharpsburg Mccullum Rd, Building B Suite 103, Newnan, GA 30265 | 2019-06-25 |
| 1356823363 | Stephen William Jacon | Specialist/Technologist | 29 Muirfield Court, Newnan, GA 30265 | 2018-09-05 |
| 1881176832 | Blueprint Psychiatry, LLC | Psychiatry & Neurology | 1601 Highway 34 E Ste A, Newnan, GA 30265 | 2018-09-05 |
| 1548790769 | Timothy Collins | Physical Therapist | 1755 Ga-34, Suite 1300, Rehab Department, Newnan, GA 30265 | 2017-06-20 |
| 1497289748 | Edible Health & Wellness,llc | Clinic/Center | 90f Glenda Trace Pmb 318, Newnan, GA 30265 | 2017-04-13 |
| Find all providers in zip 30265 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1497918627 | Bharat K Puchakayala | Internal Medicine | 1200 Lower Fayetteville Rd Ste B, Newnan, GA 30265 | 2008-07-08 |
| 1467676569 | Miriam Juliette Burnett | Internal Medicine | 560 Greison Trl, Newnan, GA 30263-1874 | 2007-04-12 |
| 1770612467 | Kimberly Ann Edwards-hall | Internal Medicine | 110 Oak Hill Blvd, Suite 200, Newnan, GA 30265-2313 | 2007-03-05 |
| 1104935063 | Samer Bedi Blackmon | Internal Medicine | 1825 Highway 34 E, St. 3000, Newnan, GA 30265-1325 | 2006-08-30 |
| 1013020791 | Linda C Cunanan | Internal Medicine | 109 Bullsboro Dr, Newnan, GA 30263-1017 | 2006-08-16 |
| 1922111608 | Romel Corpuz Cunanan | Internal Medicine | 203 Newnan Crossing Bypass, Kaiser Permanente Newnan Medical Center, Newnan, GA 30263 | 2006-08-16 |
| 1114900743 | Kay R. Crosby | Internal Medicine | 15 Cavender St, Newnan, GA 30263-1931 | 2005-11-29 |
| 1548242076 | Cleland G. Child | Internal Medicine | 2401 Newnan Crossing Blvd E, Suite 200, Newnan, GA 30265-2408 | 2005-11-18 |
| 1427437797 | Andrew Augustus Duke | Internal Medicine | 2401 Newnan Crossing Blvd E Ste 200, Newnan, GA 30265-2409 | 2015-05-20 |
| 1528473964 | Mustafa Haroon | Internal Medicine | 1200 Lower Fayetteville Rd Ste B, Newnan, GA 30265-1133 | 2014-06-24 |
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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.