Lawrence Andrew Rudolf, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2020041808 Issued in MO

Practice address

1500 Calvary Church Rd Ste B
Festus, MO 63028-4125

Phone

(636) 933-2900

Fax

(636) 933-8017

NPI assigned

Jun 18, 2018

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

Other names 1

• Larry Andrew Rudolf Other name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Saint Louis University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Clinic East CommunitiesGroup PAC ID 7214827922, shared by 6 NPIs, 573 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Missouri Home health agency, Hillsboro, MO, CCN 267270
• Mercy Home Health Home health agency, Saint Louis, MO, CCN 267565
• Mercy Home Health Home health agency, Festus, MO, CCN 267217
• Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lrudolf986371@directc.mercy.net

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.

• Mercy Clinic East Communities

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1043574940

  Single Specialty

  Medicare reassignment NPD
• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228

  Single Specialty

  Medicare reassignment NPD

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

• Mercy Hospital Jefferson

  dba Mercy Home Health

  • Home Health Agency
  • Festus, MO
  • NPI 1396748588
  Care Compare affiliation Name & address match
• Amedisys Missouri, L.L.C.

  dba Amedisys Home Health of Missouri

  • Home Health Agency
  • Hillsboro, MO
  • NPI 1164433041
  Care Compare affiliation
• Mercy Health Services LLC

  dba Mercy Home Health

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1154407112
  Care Compare affiliation
• Mercy Hospital Jefferson

  • General Acute Care Hospital
  • Festus, MO
  • NPI 1508859661
  Care Compare affiliation
• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1932693629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CALVARY CHURCH RD STE B",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284125",
            "telephone_number": "636-933-2900",
            "fax_number": "636-933-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CALVARY CHURCH RD STE B",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284125",
            "telephone_number": "636-933-2900",
            "fax_number": "636-933-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLF",
        "first_name": "LAWRENCE",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2020041808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARRY",
            "last_name": "RUDOLF",
            "middle_name": "ANDREW",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mikayla Danielle Roth, CCC-SLP
• Rouba Ghoussoub MD LLC
• Bassam A. Roukoz, M.D.
• Rebecca Lea Roux, M.A., CCC-SLP
• Craig Richard Ruble, M.D.
• Daniel Gerrit Rudolph, MD
• Elizabeth Rudolph
• Sean Christopher Rudolph
• Donald R Rueschhoff, D.C.
• Lara Ruland, LPC

• Family Medicine Physician in Festus, MO
• Providers in Festus, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.