Individual provider Active NPI

Shelly L Rudloff, LIMHP

  • Mental Health Counselor
  • Norfolk, NE
National Provider Identifier
1598820912
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
254 Issued in NE
Practice address
301 N 27TH St
Norfolk, NE 68701
Phone
(402) 644-7329
Fax
(402) 644-7403
NPI assigned
Dec 26, 2006
Last updated
Aug 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 254 NE Primary

Addresses

Primary practice location

301 N 27TH St
Norfolk, NE 68701

Mailing address

301 N 29TH Street
Norfolk, NE 68701
Phone (402) 644-7329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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

Enrollment IDStateProvider typePAC IDDetails
I20231214000319 NE Practitioner - Mental Health Counselor 0547619686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Regional Physician Services LLCGroup PAC ID 5193786168, 194 clinicians

Practice addresses (Care Compare)

47452 268 Ave
Suite C
Humphrey, NE 68642-5178
Phone (402) 923-0150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Regional Physician Services, LLC CurrentSince Jan 1, 2024 Accepting new patients
Faith Regional Physician Services, LLC CurrentSince Jan 1, 2024 Accepting new patients
Rocky Mountain Holdings, LLC PastSince Aug 27, 2023 Accepting new patients

Locations

47452 268 Ave
Ste C
Humphrey, NE 68642
Phone (402) 923-0150

110 N 29th St
Ste 201
Norfolk, NE 68701
Phone (402) 844-8121

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701
Phone (402) 844-8194

301 N 27th St
Norfolk, NE 68701
Phone (402) 844-8000

Interoperability endpoints

  • Direct secure messaging: srudloff152382@direct.nebraskamed.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1598820912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N 29TH STREET",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "68701",
            "telephone_number": "402-644-7329",
            "fax_number": "402-644-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 27TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "68701",
            "telephone_number": "402-644-7329",
            "fax_number": "402-644-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDLOFF",
        "first_name": "SHELLY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LIMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.