BRYCE RUDEK (NPI# 1679936348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679936348 |
| Entity Type | Individual |
| Full Name | BRYCE RUDEK |
| Credential | ATC |
| Practice Address |
591 Pendleton St Tahlequah OK 74464-2271 |
| Mailing Address |
1390 N Heritage Ln Apt 25 Tahlequah OK 74464-2136 |
| Practice Telephone | 9184584154 |
| Mailing Telephone | 5805125506 |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
AT4225 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
591 PENDLETON ST |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464-2271 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629581079 | Trina Hall | Speech-Language Pathologist | 591 Pendleton St, Tahlequah, OK 74464-2271 | 2017-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619355849 | Leslie Beaty | Family Medicine | 4227 Macys Pl, Moore, OK 73160-2879 | 2015-05-07 |
| 1396044764 | Michelle Rockwell | Family Medicine | 2950 S Elm Pl Ste 120, Broken Arrow, OK 74012-7816 | 2011-03-23 |
| 1902078298 | Steve Eric Randall | Family Medicine | 5104 S Sooner Rd, Oklahoma City, OK 73135-5440 | 2008-03-27 |
| 1407035447 | Steven D. King, D.o., P.c | Family Medicine | 501 E 15th St Ste 400b, Edmond, OK 73013-5040 | 2007-10-26 |
| 1356314603 | Ryan A Pitts | Family Medicine | 301 N Broadway St Ste 301, Poteau, OK 74953-3355 | 2006-02-08 |
| 1518967561 | Steven R Hardage | Family Medicine | 1110 W Will Rogers Blvd, Claremore, OK 74017 | 2005-07-29 |
| 1205836244 | T Jeffrey Emel | Family Medicine | 6475 S Yale Ave Ste 301, Tulsa, OK 74136 | 2005-07-29 |
| 1699311308 | Acellerated Interventional Orthopedics | Family Medicine | 1002 Ne Highway 66 Ste 3, Sayre, OK 73662-9312 | 2019-11-18 |
| 1154845501 | Osumc Professional Services LLC | Family Medicine | 514 Plaza Ct, Sand Springs, OK 74063-7915 | 2017-07-27 |
| 1104219385 | Avenstar Pain Specialists, Pllc | Family Medicine | 5104 S Sooner Rd, Oklahoma City, OK 73135-5440 | 2015-03-11 |
| Find all providers with the same taxonomy | ||||
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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.