Brandie Blood Rudy (NPI# 1417435199, PAC ID# 1658619333) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1417435199 |
| PAC ID by PECOS | 1658619333 |
| Professional Enrollment ID | I20190206000005 |
| Full Name | Brandie Blood Rudy |
| Organization Legal Name | STAT MD LLC |
| Address |
7724 S 5600 Suite 102 West Jordan West Jordan UT 84081-5414 |
| Phone Number | 4356040160 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7719295716 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1784 W Uinta Way, E2, Park City, UT 84098-7669 | 4356040160 | STAT MD LLC |
| 7724 S 5600, Suite 102 West Jordan, West Jordan, UT 84081-5414 | 4356040160 | STAT MD LLC |
| Organization Legal Name | STAT MD LLC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin Bryan J Huntington | Physician Assistant | Stat Md LLC | 1784 W Uinta Way, E2, Park City, UT 84098-7669 |
| Jennifer A. Knepper | Internal Medicine | Stat Md LLC | 7724 S 5600, Suite 102 West Jordan, West Jordan, UT 84081-5414 |
| Allison E Mayzel | Physician Assistant | Stat Md LLC | 1784 W Uinta Way, E2, Park City, UT 84098-7669 |
| Monica L Hull | Physician Assistant | Stat Md LLC | 1784 W Uinta Way, E2, Park City, UT 84098-7669 |
| Street Address |
7724 S 5600 SUITE 102 WEST JORDAN |
| City | WEST JORDAN |
| State | UT |
| Zip | 84081-5414 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer A. Knepper | Internal Medicine | Stat Md LLC | 7724 S 5600, Suite 102 West Jordan, West Jordan, UT 84081-5414 |
| City | WEST JORDAN |
| Zip Code | 84081 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | WEST JORDAN + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.