Bryce Rudek, ATC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

AT4225 Issued in TX

Practice address

591 Pendleton St
Tahlequah, OK 74464-2271

Phone

(918) 458-4154

NPI assigned

Mar 31, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1679936348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 N HERITAGE LN",
            "address_2": "APT 25",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642136",
            "telephone_number": "580-512-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 PENDLETON ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642271",
            "telephone_number": "918-458-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDEK",
        "first_name": "BRYCE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "AT4225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Everett Rouse, DPT
• Christopher Rowland, CMII
• Rebecca Cinnamon Roybal-Gower
• Cora Nadine Rozell, ME
• Marlena Sue Rubio-Solis, PRSS
• Jennifer Ann Ruppel, BSW
• Pamela Kay Rusco, L.C.S.W.
• Joe Russell, D.O.
• Stacy Lynn Rutherford, DNAP
• Krisstyn Elissa Ryals, LPC, CANDIDATE

• Sports Medicine (Family Medicine) Physician in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Sports Medicine (Family Medicine) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.