Active NPI
Karen Rudolph, APRN
- Family Nurse Practitioner
- Port Charlotte, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN1756082
- Practice address
- 22395 Edgewater Dr
Port Charlotte, FL 33980-2012 - Phone
- (941) 766-7222
- Fax
- (941) 766-0970
- NPI assigned
- Apr 27, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | ARNP1756082 | FL | |
| Family Nurse Practitioner | 363LF0000X | APRN1756082 | FL | Primary |
Addresses
Primary practice location
22395 Edgewater Dr
Port Charlotte, FL 33980-2012
Mailing address
PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200
Other practice location 1
2525 Harbor Blvd
Suite 202
Port Charlotte, FL 33952-5317
Phone (941) 613-3773
Other practice location 2
1390 Grand Venture Dr
North Port, FL 34286-2309
Phone (941) 257-2280
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP1756082 | FL | MD | Adult Health Nurse Practitioner |
| APRN1756082 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Cancer Specialists & Research Institute, LLC | Current | Accepting new patients | |
| Charlotte Heart & Vascular Center | Current | Accepting new patients |
Locations
1390 Grand Venture Dr
North Port, FL 34286
Phone (941) 257-2280
22395 Edgewater Dr
Fl Cancer
Port Charlotte, FL 33980
Phone (941) 766-7222
1620 Tamiami Trl
Ste 308
Pt Charlotte, FL 33948
Phone (941) 246-2482
22395 Edgewater Dr
Pt Charlotte, FL 33980
Phone (941) 766-7222
1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Cardiovascular Disease Physician
- Port Charlotte, FL
- NPI 1477266971
-
- Medical Oncology Physician
- Cape Coral, FL
- NPI 1760590962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740355200000",
"number": "1346567674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 102222",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303682222",
"telephone_number": "239-274-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22395 EDGEWATER DR",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339802012",
"telephone_number": "941-766-7222",
"fax_number": "941-766-0970"
}
],
"practiceLocations": [
{
"address_1": "2525 Harbor Blvd",
"address_2": "Suite 202",
"address_purpose": "LOCATION",
"city": "Port Charlotte",
"state": "FL",
"postal_code": "339525317",
"country_code": "US",
"telephone_number": "941-613-3773",
"fax_number": "941-629-6770",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1390 Grand Venture Dr",
"address_purpose": "LOCATION",
"city": "North Port",
"state": "FL",
"postal_code": "342862309",
"country_code": "US",
"telephone_number": "941-257-2280",
"fax_number": "941-423-8946",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUDOLPH",
"first_name": "KAREN",
"name_prefix": "Ms.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-27",
"last_updated": "2025-02-24",
"certification_date": "2025-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "ARNP1756082",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN1756082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.