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BRADLEY RUDOLPH
NPI 1376019117
Social Worker in Grand Rapids, MI

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: October 25, 2026.

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 Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Bradley Rudolph reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Thrive Counseling LLC
514 mi
Mental Health
1000 JEFFERSON ST STE 2C
Lynchburg, VA 24504
  • Reassigned Medicare billing, Michigan enrollment
  • 123 clinicians in this Medicare group
NPI 1215181300 (855) 284-7483

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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
1939 S DIVISION AVE.
GRAND RAPIDS, MI 49507
Kent County (616) 247-3815
ANNA LAUKA
Social Worker
1939 S DIVISION AVE.
GRAND RAPIDS, MI 49507
Kent County (616) 247-3815
ASHLEY HOLCOM
Community Health Worker
1939 S DIVISION AVE.
GRAND RAPIDS, MI 49507
Kent County (616) 247-3815
BROOKLYN LACKNER
Social Worker
1939 S DIVISION AVE.
GRAND RAPIDS, MI 49507
Kent County (616) 247-3815
AMANDA PETROVICH
Social Worker
1939 S DIVISION AVE.
GRAND RAPIDS, MI 49507
Kent County (616) 247-3815
GABRIEL SHYNE
Social Worker
1939 S DIVISION AVE.
GRAND RAPIDS, MI 49507
Kent County (616) 247-3815
MS. JANICE PLEASANT-PROCTOR
Social Worker (Clinical)
1939 S DIVISION AVE.
GRAND RAPIDS, MI 49507
Kent County (616) 247-3815
TRACI REYNOLDS
Social Worker
1939 S DIVISION AVE.
GRAND RAPIDS, MI 49507
Kent County (616) 247-3815

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 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.

Where is Bradley Rudolph located?

Bradley Rudolph practices at 1939 S Division Ave., Grand Rapids, MI 49507. The listed phone number is (616) 247-3815.

What is Bradley Rudolph's specialty?

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

Is Bradley Rudolph enrolled in Medicare?

Yes. Bradley Rudolph is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Bradley Rudolph's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bradley Rudolph reassigns Medicare benefits to Thrive Counseling LLC (Lynchburg, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bradley Rudolph's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Bradley Rudolph accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Bradley Rudolph as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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 8 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.