DR. CHARLES JOHN RUDOLPH JR. (NPI# 1497831267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497831267 |
| Entity Type | Individual |
| Full Name | DR. CHARLES JOHN RUDOLPH JR. |
| Credential | DO PHD |
| Practice Address |
2800 Kendallwood Parkway Suite A Kansas City MO 64119 |
| Practice Telephone | 8164535940 |
| Practice Fax Number | 8164531140 |
| Mailing Telephone | 8164535940 |
| Mailing Fax Number | 8164531140 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | R8165 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BCBS | 07661019 | 01 |
| MO | BCBS | 07661029 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346351673 | Charles Todd Rudolph | Internal Medicine | 170 Mouse Creek Rd Nw, Cleveland, TN 37312-3840 | 2006-08-31 |
| 1821047853 | Charles Rudolph IIi | Optometrist | 8600 Ward Pkwy, #710, Kansas City, MO 64114-2614 | 2006-05-08 |
| 1386636348 | Charles N Rudolph | Internal Medicine | 4510 Executive Drive, Suite 125, San Diego, CA 92121 | 2005-08-16 |
| 1871527135 | Charles E Rudolph | Psychologist | 3115 Loop 306, Suite 110, San Angelo, TX 76904-5983 | 2006-07-10 |
| Street Address |
2800 KENDALLWOOD PARKWAY SUITE A |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255978227 | Heath Bryan Coleman, Dds of Missouri II, LLC | Dentist | 5363 Ne Antioch Rd, Kansas City, MO 64119 | 2019-12-09 |
| 1528525219 | Lifestreams, LLC | Home Health | 5229 Ne 56th Place, Kansas City, MO 64119 | 2019-02-28 |
| 1740639798 | Daniel Sucher | Dentist | 5416 Ne Antioch Rd, Kansas City, MO 64119 | 2016-06-10 |
| 1902266885 | Mia Depriest | Pharmacy Technician | 4838 N Manchester Ave, Kansas City, MO 64119 | 2016-03-04 |
| 1376929976 | Abigail Blair | Physical Therapist | 8121 Ne 69 Highway, Kansas City, MO 64119 | 2015-08-05 |
| 1508273939 | Morgan Shockey | Dentist | 244 E Us Hwy 69, Ste 101, Claycomo, MO 64119 | 2014-07-17 |
| 1184865990 | Laura F Hanna | Psychologist | 3100 Ne 83rd Street, Suite#1001, Kansas City, MO 64119 | 2009-03-09 |
| 1114110483 | Heintz-sight 20/20, Inc | Optometrist | 7201 North M-1 Hwy, Gladstone, MO 64119 | 2007-08-21 |
| 1356533194 | Levelup Kids, Inc. | Optometrist | 5416 Ne Antioch Road, Kansas City, MO 64119 | 2007-08-15 |
| 1275738932 | Renee Christine Springer | Physical Therapist | 2901 Ne 72nd St, Gladstone, MO 64119 | 2007-06-20 |
| Find all providers in zip 64119 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740784214 | Bridge Integrative Medicine LLC | General Practice | 305 Nw Englewood Ct Ste 200, Kansas City, MO 64118 | 2018-03-20 |
| 1629310370 | Sarah Jane Beck | General Practice | 4332 Harrison St, Kansas City, MO 64110-1626 | 2013-03-20 |
| 1366714404 | Premise Health of Missouri Medical P C | General Practice | 9450 Ward Pkwy, Kansas City, MO 64114-3319 | 2012-02-06 |
| 1083833677 | Arthur Paul Greenberg | General Practice | 2004 Nw 82nd Ct, Kansas City, MO 64151-3763 | 2007-04-24 |
| 1235251331 | Carlos Arnoldo Fierro | General Practice | 226 N 7th St, Kansas City, KS 66101-3202 | 2007-04-06 |
| 1265465363 | Northland Medical and Wellness Center LLC | General Practice | 8355 Nw Barrybrooke Dr, Kansas City, MO 64151-1024 | 2006-07-09 |
| 1255387866 | United Medical Group, LLC | General Practice | 5701 State Ave, Suite 100, Kansas City, KS 66102-1236 | 2006-05-25 |
| 1720055668 | Coatney Clinic, Inc | General Practice | 6235 E Truman Rd, Kansas City, MO 64126-2631 | 2006-02-28 |
| 1811552029 | Georgeanne Emerson Cornell | General Practice | 2301 Holmes Street, Kansas City, MO 64108 | 2019-05-02 |
| 1700324738 | Sara Jane Anderson | General Practice | 1000 E 24th St, Kansas City, MO 64108-2776 | 2017-02-09 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 64119 |
Please comment or provide details below to improve the information on DR. CHARLES JOHN RUDOLPH JR..
| 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.