DR. KEVIN PATRICK RUDDELL (NPI# 1013072669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013072669 |
| Entity Type | Individual |
| Full Name | DR. KEVIN PATRICK RUDDELL |
| Credential | DC |
| Practice Address |
1117 16th Avenue Lewiston ID 83501 |
| Practice Telephone | 2087438401 |
| Practice Fax Number | 2087438722 |
| Mailing Telephone | 2087438401 |
| Mailing Fax Number | 2087438722 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHIR 725 | ID | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEPT LABOR & INDUSTRIES | 0190459 | 01 | |
| ID | BLUE CROSS | C7259 | 01 |
| ID | REGENCE | 000010024191 | 01 |
| Street Address |
1117 16TH AVENUE |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770648388 | Brian T Ruddell | Chiropractor | 1117 16th Avenue, Lewiston, ID 83501 | 2006-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194249730 | William M Colasante | Chiropractor | 184 Webster St Ste 100, Lewiston, ME 04240-5558 | 2017-07-26 |
| 1780115170 | Joshua D Reed | Chiropractor | 765 Cayuga Street, Suite 3, Lewiston, NY 14092-1726 | 2017-03-27 |
| 1093102428 | Codi Fuller | Chiropractor | 30207 Rosenkrantz Rd, Lewiston, ID 83501-5229 | 2015-04-23 |
| 1568806156 | Dr. Thomas R. Boyer, PC | Chiropractor | 717 D St, Lewiston, ID 83501-1826 | 2013-04-25 |
| 1790028819 | David R Chicoine | Chiropractor | 81 Old Greene Rd, Lewiston, ME 04240-3623 | 2013-03-27 |
| 1871761148 | Clearwater Chiropractic & Acupuncture, P.a. | Chiropractor | 3316 1/2 4th St Ste 4a, Lewiston, ID 83501-4460 | 2008-02-20 |
| 1225235906 | Ruddell Chiropractic Clinic | Chiropractor | 1117 16th Ave, Lewiston, ID 83501-3739 | 2007-06-27 |
| 1952421034 | Kevin M Augustine | Chiropractor | 769 Cayuga St, Suite 1, Lewiston, NY 14092-1723 | 2007-03-30 |
| 1831219047 | Glenn Nicholas Jr. | Chiropractor | 315 Skyline Dr, Lewiston, ID 83501-4220 | 2007-03-30 |
| 1811036346 | Functional Spine Center, Pa | Chiropractor | 185 Webster St Ste 15, Lewiston, ME 04240-5500 | 2007-02-05 |
| Find all providers in LEWISTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.