DR. PRIYA RUDOLPH (NPI# 1871587113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871587113 |
| Entity Type | Individual |
| Full Name | DR. PRIYA RUDOLPH |
| Credential | MD, PHD |
| Practice Address |
125 King Ave Suite 200 Athens GA 30606-6734 |
| Mailing Address |
1835 Savoy Dr Suite 300 Atlanta GA 30341-1072 |
| Practice Telephone | 7063694478 |
| Practice Fax Number | 7063536639 |
| Mailing Telephone | 7063694478 |
| Mailing Fax Number | 7063536639 |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2020-05-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
068852 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RR MEDICARE | P01155926 | 01 |
| GA | 003129225C | 05 | |
| GA | 003129225B | 05 |
| Street Address |
125 KING AVE SUITE 200 |
| City | ATHENS |
| State | GA |
| Zip Code | 30606-6734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215320098 | Athens Orthopedic Clinic, Pa | Orthopaedic Surgery | 125 King Ave, Athens, GA 30606-6734 | 2015-03-18 |
| 1114264694 | Aynaddis Fekadu | Nurse Practitioner | 125 King Ave, Suite 200, Athens, GA 30606-6734 | 2013-01-03 |
| 1700137874 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 125 King Ave, 2nd Floor, Suite 200, Athens, GA 30606-6734 | 2012-09-28 |
| 1063656106 | Jenifer Susan Miller | Nurse Practitioner | 125 King Ave, Suite 200, Athens, GA 30606-6734 | 2009-04-20 |
| 1265640247 | Georgia Cancer Specialists I PC | Internal Medicine | 125 King Ave, Suite 200, Athens, GA 30606-6734 | 2007-05-21 |
| 1306059613 | Charles Lawton Ogburn IIi | Orthopaedic Surgery | 125 King Ave, Athens, GA 30606-6734 | 2007-05-07 |
| 1801011473 | Nirav S. Dhruva | Internal Medicine | 125 King Ave, Suite 200, Athens, GA 30606-6734 | 2007-04-17 |
| 1750419487 | Ranjana Satyamurthy Bhargava | Internal Medicine | 125 King Ave, Suite 200, Athens, GA 30606-6734 | 2007-03-02 |
| 1952485377 | Dortheann Metzinger | Social Worker | 125 King Ave, Suite 200, Athens, GA 30606-6734 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816962 | Kofi Darkwa Seffah | Student in an Organized Health Care Education/Training Program | 1199 Prince Ave #70, 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-09-16 |
| 1831712363 | Rebecca John | Licensed Practical Nurse | 240 Mitchel Bridge Road, Athens, GA 30606 | 2020-05-19 |
| 1497375612 | Alfred Ka-shing Wong | Student in an Organized Health Care Education/Training Program | 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-04-17 |
| 1881223956 | Lauren Fesperman | Nurse Practitioner | 242 King Ave Ste 130, Athens, GA 30606 | 2020-04-02 |
| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1255981700 | Carol Cameron Cready-pyle | Social Worker | 1551 Jennings Mill Pkwy Ste 1700, Athens, GA 30606 | 2019-09-17 |
| 1013576016 | Lauren Gruendling | Nurse Practitioner | 242 King Avenue, Suite 210, Athens, GA 30606 | 2019-06-12 |
| 1760045223 | Dominic Ofosu Amakye | Student in an Organized Health Care Education/Training Program | 1270 Prince Avenue Suite 201, Athens, GA 30606 | 2019-04-19 |
| 1740740422 | Juan G Salazar Castillo | Student in an Organized Health Care Education/Training Program | Community Internal Medicine of Athens, 1500 Oglethorpe Ave Suite 200d, Athens, GA 30606 | 2019-03-20 |
| 1750869020 | Jennifer Emily Chapman | Physical Therapist | 1021 Parkway Blvd Ste 101, Athens, GA 30606 | 2018-07-30 |
| Find all providers in zip 30606 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942588918 | Gustavo Figueiredo Marcondes Westin | Internal Medicine | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2011-07-25 |
| 1548410400 | Ali M. Sayed | Internal Medicine | 125 King Ave Ste 200, Athens, GA 30606-6710 | 2008-09-26 |
| 1306005798 | Shawn Tai | Internal Medicine | 115 Medical Cir Ste 106, Athens, TX 75751 | 2008-06-02 |
| 1790854255 | Southeast Cancer Network, Inc | Internal Medicine | 22281 Us Highway 72, Ste B, Athens, AL 35613-2600 | 2006-11-07 |
| 1528451978 | Athens Regional University Cancer Center, LLC | Internal Medicine | 3320 Old Jefferson Rd, Building 700, Athens, GA 30607-1400 | 2015-03-10 |
| 1265640247 | Georgia Cancer Specialists I PC | Internal Medicine | 125 King Ave, Suite 200, Athens, GA 30606-6734 | 2007-05-21 |
| 1235356247 | Frederick Lee Flynt Jr. | Internal Medicine | 3320 Old Jefferson Rd, Bldg 700, Athens, GA 30607-1400 | 2007-04-19 |
| 1750419487 | Ranjana Satyamurthy Bhargava | Internal Medicine | 125 King Ave, Suite 200, Athens, GA 30606-6734 | 2007-03-02 |
| 1891843819 | Tennessee Cancer Specialists Pllc | Internal Medicine | 1114 W Madison Ave, Athens Regional Medical Center, Athens, TN 37303-4150 | 2007-01-08 |
| 1730236688 | Cynthia L Shepherd | Internal Medicine | 3320 Old Jefferson Rd, Bldg 700, Athens, GA 30607 | 2007-01-04 |
| Find all providers in ATHENS | ||||
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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.