John Stephen Rudderow

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

0102205193 Issued in VA

Practice address

3 Riverside Cir
Roanoke, VA 24016

Phone

(972) 978-8758

NPI assigned

Apr 2, 2012

Last updated

Dec 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carilion Home Care Services - Roanoke Home health agency, Roanoke, VA, CCN 497258
• Carilion Medical Center Hospital, Roanoke, VA, CCN 490024
• Carilion Franklin Memorial Hospital Hospital, Rocky Mount, VA, CCN 490089
• Carilion New River Valley Medical Center Hospital, Christiansburg, VA, CCN 490042

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrudderow44862@direct.carilionclinic.org

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

• Carilion Medical Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1730123472
  Medicare reassignment Care Compare group NPD
• Carilion Giles Community Hospital

  • Critical Access Hospital
  • Pearisburg, VA
  • NPI 1194718304
  Medicare reassignment NPD
• Carilion Healthcare Corporation

  dba Bridgewater College Student Health Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1447206370
  Medicare reassignment NPD
• Carilion Rockbridge Community Hospital

  • Critical Access Hospital
  • Lexington, VA
  • NPI 1518950484
  Medicare reassignment
• Carilion Giles Community Hospital

  • Durable Medical Equipment & Medical Supplies
  • Galax, VA
  • NPI 1639980493
  NPD
• Carilion Healthcare Corporation

  • Durable Medical Equipment & Medical Supplies
  • Blacksburg, VA
  • NPI 1407667256
  NPD
• Carilion Medical Center

  dba Carilion Clinic - DME - Westlake

  • Durable Medical Equipment & Medical Supplies
  • Hardy, VA
  • NPI 1073324810
  NPD
• Carilion Medical Center

  dba Carilion Roanoke Memorial Hospital

  • General Acute Care Hospital
  • Roanoke, VA
  • NPI 1033102942
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carilion Franklin Memorial Hospital

  • General Acute Care Hospital
  • Rocky Mount, VA
  • NPI 1710970918
  Care Compare affiliation
• Carilion Medical Center

  dba Carilion Roanoke Memorial Hospital

  • General Acute Care Hospital
  • Roanoke, VA
  • NPI 1033102942
  Care Compare affiliation
• Carilion Medical Center

  dba Carilion Clinic Home Health

  • Home Health Agency
  • Roanoke, VA
  • NPI 1073506002
  Care Compare affiliation
• Carilion New River Valley Medical Center

  • General Acute Care Hospital
  • Christiansburg, VA
  • NPI 1376536573
  Care Compare affiliation

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1043576267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 N GLADSTONE BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641231208",
            "telephone_number": "972-978-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24016",
            "telephone_number": "972-978-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDEROW",
        "first_name": "JOHN",
        "middle_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-02",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0102205193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrudderow44862@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jrudderow44862@direct.carilionclinic.org",
            "address_1": "3 Riverside Cir",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "24016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jonathan Rozenberg
• Ivan Rubiano, DPM
• Edmundo Raul Rubio, MD
• Marrieth Garciela Rubio, M.D.
• Joey A Rudd Jr., PAC
• April Ruffin, MD
• Daniel B. Rukstalis, M.D.
• Christopher Chad Runyon, LPC
• James Caleb Runyon, APRN
• Taylor Jones Runyon, PA-C

• Surgery Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.