Kristin Rudy, LCSWA, LCASA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P018010 Issued in NC

Practice address

615 Shipyard Blvd
Wilmington, NC 28412-6431

Phone

(910) 343-0145

Fax

(910) 202-9966

NPI assigned

Jul 25, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Coastal Horizons Center, Inc.Group PAC ID 9739267964, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Coastal Horizons Center, Inc.

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1922022607
  Medicare reassignment Care Compare group NPD
• Coastal Horizons Center Inc

  • Community/Behavioral Health Agency
  • Rocky Point, NC
  • NPI 1063082592
  NPD
• Coastal Horizons Center, Inc.

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1790985448
  NPD

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1457087249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145",
            "fax_number": "910-202-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDY",
        "first_name": "KRISTIN",
        "credential": "LCSWA, LCASA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "28378",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P018010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Natasha Rubio, DO
• Casey Dawn Rucker, PA-C
• Joy Rudder-Wells, S.L.P.
• Michelle Rena Rudolph, LCMHC
• Kristen Danielle Rudy, M.S., ATR, NCC, LPC
• Mary Kathryn Rudyk, M.D.
• Omobola Ruff
• Hugh Ruger Jr.
• Victoria Rugo, PT
• Katherine Marilia Ruiz Gonzalez, MD

• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.