Amy Rudolph, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

105449 Issued in MO

Practice address

10000 W 75TH St
Suite 250
Merriam, KS 66204-2209

Phone

(913) 894-1910

NPI assigned

Jan 22, 2009

Last updated

Jan 22, 2009By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1467690883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21117 E 50TH TERRACE DR S",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640152257",
            "telephone_number": "816-229-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W 75TH ST",
            "address_2": "SUITE 250",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662042209",
            "telephone_number": "913-894-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "AMY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-22",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "105449",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-01867",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS STATE BOARD OF HEALING ARTS",
            "identifier": "11-01867",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI STATE BOARD OF REGISTRATION FOR THE HEALING ARTS",
            "identifier": "105449",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Arman Saber
• Thaju Salam, M.D.

• Physical Therapist in Merriam, KS
• Providers in Merriam, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.