BRADLEY RUDOLPH
NPI 1376019117
Social Worker in Grand Rapids, MI

Q: What is Bradley Rudolph's NPI number?

The NPI number for Bradley Rudolph is 1376019117. It was assigned to this individual provider in the NPPES registry on October 19, 2018.

Q: What is Bradley Rudolph's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Rudolph was last updated on October 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 19, 2018PECOS Enrolled

1939 S DIVISION AVE., GRAND RAPIDS, MI 49507(616) 247-3815(616) 245-0450 Get Directions Write a Review

NPPES record last updated: October 19, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Bradley Rudolph NPPES

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

BRADLEY RUDOLPH (NPI 1376019117) is an individual social worker in Grand Rapids, Michigan, licensed in Michigan (6801103455) and active in the NPI registry since October 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376019117

Entity TypeIndividualMale

Primary Taxonomy104100000X

Provider Legal NameBRADLEY RUDOLPH

Location Address1939 S DIVISION AVE.Grand Rapids, MI 49507

Mailing Address1939 S Division Ave.Grand Rapids, MI 49507 · (616) 247-3815 · Fax (616) 245-0450

Phone(616) 247-3815

Fax(616) 245-0450

Sole ProprietorNo

Enumeration DateOctober 19, 2018

✔ NPI 1376019117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in MI · 6801103455

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

1939 S DIVISION AVE., Grand Rapids, MI 49507

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bradley Rudolph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TERRI A. HUMMEL

Social Worker