MRS. KELLY MARIE RUDROFF RN, MSN
NPI 1609216159
Nurse Practitioner - Family in Saint Louis, MO

Active since June 28, 2013PECOS Enrolled
915 N GRAND BLVD, SAINT LOUIS, MO 63106(314) 652-4100 Get Directions Write a Review

NPPES record last updated: April 14, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 14, 2018, Mar 2, 2017 (2 updates tracked since 2017).

About Mrs. Kelly Marie Rudroff Rn, Msn NPPES

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

MRS. KELLY MARIE RUDROFF RN, MSN (NPI 1609216159) is an individual family provider in Saint Louis, Missouri, licensed in Missouri (2016042952) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609216159
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. KELLY MARIE RUDROFFCredential: RN, MSN
Location Address915 N GRAND BLVDSaint Louis, MO 63106
Mailing Address2909 Shenandoah AveSaint Louis, MO 63104-1739 · (314) 583-7698
Sole ProprietorNo
Enumeration DateJune 28, 2013
Last NPPES UpdateApril 14, 20182 updates tracked since enumeration
NPI 1609216159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in MO · 2016042952
Also ListedRegistered NurseTaxonomy 163W00000X · License 900243 (MS)
915 N GRAND BLVD, Saint Louis, MO 63106

Other Identifiers 1

Other1609216159MO · Unsure Of Issuer

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mrs. Kelly Marie Rudroff Rn, Msn 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63106 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Pharmacist
915 N GRAND BLVD, ROOM A830
SAINT LOUIS, MO 63106
Medicare Defined Swing Bed Unit
915 N GRAND BLVD
SAINT LOUIS, MO 63106
Internal Medicine
915 N GRAND BLVD
SAINT LOUIS, MO 63106
Nurse Practitioner (Family)
915 N GRAND BLVD
SAINT LOUIS, MO 63106
Internal Medicine
915 N GRAND BLVD, ST. LOUIS VAMC
SAINT LOUIS, MO 63106
Nurse Practitioner (Adult Health)
915 N GRAND BLVD, EMERGENCY ROOM
SAINT LOUIS, MO 63106
Pharmacist
915 N GRAND BLVD, 119 JC
SAINT LOUIS, MO 63106
Pharmacist (Pharmacotherapy)
915 N GRAND BLVD
SAINT LOUIS, MO 63106

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609216159, enumerated as an "individual" on June 28, 2013.

The provider is located at 915 N GRAND BLVD SAINT LOUIS, MO 63106 and the phone number is (314) 652-4100.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.