Individual provider Active NPI

Shauna E Rudd

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1215695960
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
256281 Issued in KY
Practice address
176 Market St Apt 202
Lexington, KY 40507-1146
Phone
(606) 272-0243
NPI assigned
Nov 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 256281 KY Primary

Addresses

Primary practice location

176 Market St Apt 202
Lexington, KY 40507-1146

Mailing address

176 Market St Apt 202
Lexington, KY 40507-1146
Phone (606) 272-0243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220127001674 KY Practitioner - Clinical Social Worker 1658763461 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alteri, LLC Clinical CurrentSince Jul 1, 2024 Accepting new patients
Alteri, LLC Clinical CurrentSince Jul 1, 2024 Accepting new patients
Better Mental Health Ky, LLC Clinical CurrentSince Jan 5, 2022 Accepting new patients

Locations

642 E Lexington Ave
Danville, KY 40422
Phone (859) 209-2269

1 Physicians Park
Ste B
Frankfort, KY 40601
Phone (502) 699-2714

938 Louisville Rd
Ste 300
Frankfort, KY 40601

190 W Lowry Ln
Ste 200
Lexington, KY 40503
Phone (859) 277-0099

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1215695960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 MARKET ST APT 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405071146",
            "telephone_number": "606-272-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 MARKET ST APT 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405071146",
            "telephone_number": "606-272-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "SHAUNA",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "256281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.