Nikea Degler Rudloff, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2014037304 Issued in MO

Practice address

54 Hospital Dr
Osage Beach, MO 65065-3050

Phone

(573) 302-2230

Fax

(573) 302-2231

NPI assigned

Dec 16, 2014

Sex

Female

Sole proprietor

No

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": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1972901338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-302-2230",
            "fax_number": "573-302-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-302-2230",
            "fax_number": "573-302-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDLOFF",
        "first_name": "NIKEA",
        "middle_name": "DEGLER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2014037304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghann Robertson, RD, LD
• Matthew Ryan Rockelman
• Cali Lynn Rogers
• Ryan Willard Rogers, PA-C
• Tammy Patricia Roney, LMT
• Parker Trent Russell, MD
• Trent K Russell, M.D.
• Holly E. Sabourin, PHYSICAL THERAPIST
• Harbaksh Singh Sangha, MD
• Jacqueline E Santamarina, MD

• All providers in Osage Beach, MO
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; 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.