Kathleen Simms Rudolf, O. D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5891/T2805 Issued in OH

Practice address

2850 Centre Dr Ste 6a
Beavercreek, OH 45324-8611

Phone

(937) 294-4060

Fax

(937) 306-5245

NPI assigned

Jul 24, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Family First Vision Care Kentucky LLCGroup PAC ID 3577975291, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family First Vision Care Kentucky, LLC

  • Optometrist
  • Fort Mitchell, KY
  • NPI 1396396750

  OH

  Medicare reassignment Care Compare group NPD
• Dayton Optometric Center Inc.

  • Optometrist
  • Dayton, OH
  • NPI 1194722603
  Medicare reassignment NPD
• Family First Vision Care, LLC

  • Optometrist
  • Columbus, OH
  • NPI 1427462183
  Medicare reassignment NPD
• Optometric Management Group LLC

  • Optometrist
  • Powell, OH
  • NPI 1265534093
  Medicare reassignment NPD
• Dayton Optometric Center Inc.

  • Optometrist
  • Dayton, OH
  • NPI 1841460482
  NPD
• Family First Vision Care Kentucky, LLC

  • Optometrist
  • Beavercreek, OH
  • NPI 1164142444
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1033349055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 CENTRE DR STE 6A",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "453248611",
            "telephone_number": "937-294-4060",
            "fax_number": "937-306-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 CENTRE DR STE 6A",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "453248611",
            "telephone_number": "937-294-4060",
            "fax_number": "937-306-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLF",
        "first_name": "KATHLEEN",
        "middle_name": "SIMMS",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5891/T2805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Robin Roush, D.C.
• Vicki Sue Roush, DC
• Amber Routt, MSN CNP
• Tara Marie Rower, CNP
• Margaret H. Roy, M.S., LPCC, IMFT
• Sandra L Rue, RN
• Chloe Ruggiero
• Mary Runnoe, MS, LPCC
• Stephanie N Russell, FNP-BC
• Shalini Aggarwal Ryan, DO

• Optometrist in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.