Kimberly Rudd, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4143 Issued in NE

Practice address

17055 Frances St Ste 100
Omaha, NE 68130-4655

Phone

(402) 280-3555

NPI assigned

Sep 21, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Rudeen Former name

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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1487260899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S 31ST AVE APT 4206",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681311407",
            "telephone_number": "208-841-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17055 FRANCES ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681304655",
            "telephone_number": "402-280-3555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "880 Park Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "NE",
            "postal_code": "680596845",
            "country_code": "US",
            "telephone_number": "402-253-3079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDD",
        "first_name": "KIMBERLY",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2021-09-08",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "RUDEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Temple S Rucker, MD
• William M Rucker
• Michael Eugene Ruckman
• Alison D Ruckstuhl
• Justin Rudd
• Lacy Rudder, PLDAC
• Amy L Ruddick, APRN-FNP
• Laura Rudebusch, RN
• Tara Rudebush
• Meredith C. Rudish, RN, CNM

• Physical Therapist in Omaha, NE
• Providers in Omaha, NE by specialty
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.