Individual provider Active NPI

Kristi Jo Rudolf, OTR

  • Occupational Therapist
  • Fargo, ND
National Provider Identifier
1427085489
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
832 Issued in ND
Practice address
2101 Elm St N
130R
Fargo, ND 58102-2417
Phone
(701) 232-3241
Fax
(701) 239-3721
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1053141 ND
Occupational Therapist 225X00000X 832 ND Primary

Addresses

Primary practice location

2101 Elm St N
130R
Fargo, ND 58102-2417

Mailing address

4804 37TH Ave N
Reiles Acres, ND 58102-5438
Phone (701) 306-1817

Other names 1

  • Ms. Kristi Jo Andrews Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
832NDMDOptometrist
1053141NDMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1427085489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 37TH AVE N",
            "city": "REILES ACRES",
            "state": "ND",
            "postal_code": "581025438",
            "telephone_number": "701-306-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ELM ST N",
            "address_2": "130R",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022417",
            "telephone_number": "701-232-3241",
            "fax_number": "701-239-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLF",
        "first_name": "KRISTI",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ND",
            "license": "1053141",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "ANDREWS",
            "middle_name": "JO",
            "prefix": "MS.",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.