Kristina Ruddle D.C. LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2016000080 Issued in MO

Legal business name

KRISTINA RUDDLE D.C. LLC

Practice address

4455 Telegraph Rd Ste 250
Saint Louis, MO 63129-3354

Phone

(314) 416-4900

Fax

(314) 487-4669

NPI assigned

Jan 25, 2016

Last updated

Jan 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristina Ruddle, D.C.NPI 1376909135

Title

Doctor/Owner

Phone

(314) 775-5396

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristina Ruddle, D.C.

  • Chiropractor
  • Saint Louis, MO
  • NPI 1376909135
  Authorized official Same address or phone

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1487011268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 COUNTRY CLUB PARC CT",
            "city": "IMPERIAL",
            "state": "MO",
            "postal_code": "630523626",
            "telephone_number": "314-775-5396",
            "fax_number": "314-487-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 TELEGRAPH RD STE 250",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631293354",
            "telephone_number": "314-416-4900",
            "fax_number": "314-487-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTINA RUDDLE D.C. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "RUDDLE",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "314-775-5396",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2016000080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.