Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1376561464 Individual Practitioner Male Practitioner

Dr. Joseph Rudolph , MD

Pediatrics • Fenton, MO

Professional Overview & Biography Verified Profile Summary

Dr. Joseph Rudolph, MD is a registered healthcare professional specializing in Pediatrics in Fenton, MO. Practice services are available at 1011 BOWLES AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1011 Bowles Ave
Suite 300

Fenton, MO 630262395

Telephone 3144965000
Fax 3144965015
Associated Practice Facility / Clinic
🏢 Peter J Anderson, Md Pc Facility NPI 1568433639

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Fenton, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.0 Yrs
State Avg: 19.4 Yrs
Regional Practice Density
12 Specialists

Practicing in Fenton, MO (1616 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License MO MOR4E01

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
202083069 (MO)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Dr. Lawrence Boveri , MD

Obstetrics & Gynecology

NPI 1003841388

Doctor of Medicine (M.D.)

Lita Lapins , FNP

Nurse Practitioner - Family

NPI 1013253699

Family Nurse Practitioner

Allison Brown , FNP

Nurse Practitioner - Family

NPI 1023729605

Family Nurse Practitioner

Denise Blackburn , APRN, FNP-BC

Nurse Practitioner - Family

NPI 1043568280

Advanced Practice Registered Nurse, Family Nurse Practitioner (Board Certified)

Tiffany Harold , APRN

Nurse Practitioner - Women's Health

NPI 1083120208

Advanced Practice Registered Nurse

NPI 1083618904

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 02, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location September 02, 2009

Registered at 1011 BOWLES AVE, SUITE 300, FENTON, MO 630262395 (Tel: 3144965000)

📍
Updated Business Mailing Address September 02, 2009

Registered at 10777 SUNSET OFFICE DR, SUITE 310, SAINT LOUIS, MO 631271019 (Tel: 3148225900)

👤
Provider Name / Credentials Updated September 02, 2009

Recorded as JOSEPH RUDOLPH, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 02, 2009

Pediatrics (License #MOR4E01 in MO)

🟢
Initial NPI Registration & Enumeration July 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376561464
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 17, 2006
Last Update: September 02, 2009
Sole Proprietor: No

Mailing Address

10777 Sunset Office Dr, Suite 310

Saint Louis, MO 631271019

Phone: 3148225900

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.