Active NPI
Kenneth Curtis Dudley, PH.D.
- Psychologist
- Baker City, OR
National Provider Identifier
1760416010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1656
- Practice address
- 1705 Main St
Suite 501
Baker City, OR 97814-3453 - Phone
- (541) 523-4715
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1656 | OR | Primary |
Addresses
Primary practice location
1705 Main St
Suite 501
Baker City, OR 97814-3453
Mailing address
PO Box 324
Baker City, OR 97814-0324
Phone (541) 523-4715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 83346 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760416010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 324",
"city": "BAKER CITY",
"state": "OR",
"postal_code": "978140324",
"telephone_number": "541-523-4715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 MAIN ST",
"address_2": "SUITE 501",
"city": "BAKER CITY",
"state": "OR",
"postal_code": "978143453",
"telephone_number": "541-523-4715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "KENNETH",
"middle_name": "CURTIS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "1656",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "83346",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baker City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.