{"npi":"1346351673","type":"NPI-1","status":"active","name":{"display":"Dr. Charles Rudolph M.D.","other":[],"first":"CHARLES","last":"RUDOLPH","credential":"M.D."},"specialty":{"primary_taxonomy":"207R00000X","primary_taxonomy_description":"Internal Medicine","slug":"internal-medicine","schema_org_specialty":"Internal","all":[{"code":"207R00000X","description":"Internal Medicine","primary":true,"state":"TN","license":"MD32155"}]},"addresses":[{"purpose":"LOCATION","street_1":"170 MOUSE CREEK RD NW","city":"CLEVELAND","state":"TN","postal_code":"373123840","country_code":"US","phone":"4234581426","fax":"4237901276"},{"purpose":"MAILING","street_1":"1025 PEERLESS XING NW","city":"CLEVELAND","state":"TN","postal_code":"373123764","country_code":"US","phone":"4234765990","fax":"4234765887"}],"license":{"state":"TN","number":"MD32155"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"000931499D","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"3855171","state":"TN","issuer":null},{"type_code":"05","label":"Medicaid","value":"00931499A","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"3855172","state":"TN","issuer":null},{"type_code":"01","label":"Other","value":"3148810","state":"TN","issuer":"BCBS OF TENNESSEE"},{"type_code":"01","label":"Other","value":"4150063","state":"TN","issuer":"BLUE CROSS"},{"type_code":"01","label":"Other","value":"P00199940","state":"TN","issuer":"RAILROAD MEDICARE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20050202000872","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"TN","pac_id":"4284685678"},{"enrlmt_id":"I20180912000786","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"NC","pac_id":"4284685678"},{"enrlmt_id":"I20220825002817","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"GA","pac_id":"4284685678"}]},"enumeration_date":"2006-08-31","last_updated":"2024-04-22","_meta":{"source":"NPPES","snapshot_date":"2024-04-22","doc_url":"https://findmynpi.com/api"}}