DR. CORNELIO RODERICK RUPERTO MD NPI 1316065204

NPI Information

  • NPI: 1316065204
  • Provider Name: DR. CORNELIO RODERICK RUPERTO, MD
  • Classification: Psychiatry & Neurology - 2084P0804X
  • Specialization: Child & Adolescent Psychiatry
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6620 SHALLOWFORD RD
    SUITE 200
    LEWISVILLE, NC
    ZIP 27023
  • Phone: (336) 945-0345

Map and Directions

Get Directions

NPI Details

DR. Cornelio Roderick Ruperto, MD is a child and adolescent psychiatry psychiatry neurology in Lewisville, NC. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. DR. Cornelio Roderick Ruperto, MD NPI is 1316065204. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6620 SHALLOWFORD RD
SUITE 200
LEWISVILLE, NC
ZIP 27023-504
Phone: (336) 945-0345
Fax: (336) 945-0342

The NPI 1316065204 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/27/2007 and was last updated on 10/25/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0800XPsychiatry & NeurologyPsychiatry2006-01732NORTH CAROLINANo
22084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry2006-01732NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15900260MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI