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COUNCILL C RUDOLPH MD
NPI 1194760660
Surgery in Manchester, TN

Active since June 18, 2006Opted out of Medicare · through Oct 1, 2027
822 MCARTHUR ST, MANCHESTER, TN 37355(931) 723-7121(931) 723-7133 Get Directions Write a Review

NPPES record last updated: April 14, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Councill C Rudolph Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNCILL C RUDOLPH MD (NPI 1194760660) is an individual surgery provider in Manchester, Tennessee, licensed in Tennessee (MD0000025899) and active in the NPI registry since June 2006. He has opted out of Medicare through October 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1194760660
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameCOUNCILL C RUDOLPHCredential: MD
Location Address822 MCARTHUR STManchester, TN 37355-2324
Mailing Address15 Veterans DrDecherd, TN 37324-3887 · (931) 962-2273 · Fax (931) 962-2202
Phone(931) 723-7121
Fax(931) 723-7133
Sole ProprietorNo
Enumeration DateJune 18, 2006
Last NPPES UpdateApril 14, 2016
✔ NPI 1194760660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in TN · MD0000025899
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
822 MCARTHUR ST, Manchester, TN 37355
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Other Identifiers 3

Medicaid3091133TN
Medicare UPING03049TN
Medicare PIN3091133TN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Councill C Rudolph Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2015 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2015
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37355 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$66.01 typical visit price
range $16.72 – $131.41
Typical copayment $16.50 (range $4.18 – $32.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Councill Rudolph's NPI number?

The NPI number for Councill Rudolph is 1194760660. It was assigned to this individual provider in the NPPES registry on June 18, 2006.

Where is Councill Rudolph located?

Councill Rudolph practices at 822 Mcarthur St, Manchester, TN 37355. The listed phone number is (931) 723-7121.

What is Councill Rudolph's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Councill Rudolph enrolled in Medicare?

No. Councill Rudolph has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Councill Rudolph was last updated on April 14, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.