Amanda B Rudolph, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

162093 Issued in TX

Practice address

1011 W Grove St Ste 120
Kaufman, TX 75142-1883

Phone

(972) 932-1319

Fax

(972) 932-1396

NPI assigned

Mar 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

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.

• Kids Healthcare, Inc

  • Pediatrics Physician
  • Kaufman, TX
  • NPI 1376732339
  NPD (past)
• Ochsner Clinic LLC

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD (past)

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1043452972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 VETERANS MEMORIAL BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700065210",
            "telephone_number": "504-887-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W GROVE ST STE 120",
            "city": "KAUFMAN",
            "state": "TX",
            "postal_code": "751421883",
            "telephone_number": "972-932-1319",
            "fax_number": "972-932-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "AMANDA",
        "middle_name": "B",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP05388",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "162093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09079528",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1552992",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelin Roberts, AGNP-C
• Sofia Rodriguez, DO
• Rooted in Grace Counseling PLLC
• Rosehaven Retirement Residences, Inc
• Rosehaven Retirement Residences, Inc
• Jennifer Leigh Russell, LPC
• Samantha White LPC LLC
• Alexandra Edith Samarripa, RD
• Cecilia Sanchez, CD (DONA)
• Sally K Sandlin, ST

• Pediatric Nurse Practitioner in Kaufman, TX
• Providers in Kaufman, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.