Jessica Lynn Rudolph, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-005345 Issued in AZ

Practice address

2940 E Banner Gateway Dr Ste 425
Gilbert, AZ 85234-2177

Phone

(480) 813-7900

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

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 AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White Mountain Physical Therapy LTDGroup PAC ID 0446142111, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• White Mountain Physical Therapy LTD

  • Physical Therapist
  • Show Low, AZ
  • NPI 1750385654
  Medicare reassignment Care Compare group NPD
• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Glendale, AZ
  • NPI 1235654237
  NPD (past)
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy and Rehabilitation

  • Physical Therapy Clinic/Center
  • Peoria, AZ
  • NPI 1285271684
  NPD (past)
• Dynamic Rehab Hand Therapy, Inc

  dba Dynamic Rehab

  • Customized Equipment (DME)
  • Gilbert, AZ
  • NPI 1295926350
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1679669220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 E JULIAN DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951651",
            "telephone_number": "480-917-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 E BANNER GATEWAY DR STE 425",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342177",
            "telephone_number": "480-813-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5345",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-005345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darin A Rudd, LMT
• Cynthia Eva Ruddell, MS CCC-SLP
• Trent Rudebeck, PT, DPT
• Rachel Rudell
• Edward Tucker Rudisill, DDS
• Zachary Rudolph
• Susan Beth Rueling
• Maria Ruff
• Sennette Ruff
• Amy H Ruggeri, MD

• Physical Therapist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.