Daniel Gerrit Rudolph, MD
Daniel Gerrit Rudolph is a Pediatrics Physician provider (Pediatrics) practicing in Festus, MO, registered in the NPPES registry with NPI 1861477085 since 2005. The credential MD stands for Doctor of Medicine. Practices at Ccpartners LLC (listed at the same practice address in NPPES).
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1861477085 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Daniel Gerrit Rudolph |
| Credential | MD |
| Sex | Male |
| Practice address | 35 GOODWIN DR, Festus, MO, 63028 |
| Phone | 6369334141 |
| Fax | 6369317007 |
| Enumeration date | 2005-12-09 |
| Last updated in NPPES | 2023-09-21 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 208000000X | Pediatrics Physician | Primary | 105323 | MO |
MD — Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203936901 | Medicaid | MO | — |
Copy-ready billing details
Provider: Daniel Rudolph, MD NPI: 1861477085 Taxonomy: 208000000X (Pediatrics Physician) Address: 35 GOODWIN DR, Festus, MO, 63028
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1013992189 | Joshua Boldt | Individual | Pediatrics Physician | Festus, MO |
| 1457336166 | Erin Donovan | Individual | Pediatric Nurse Practitioner | Festus, MO |
| 1487857033 | Ccpartners LLC | Organization | Pediatric Adolescent Medicine Physician | Festus, MO |
| 1104215086 | Louise Jadwisiak | Individual | Pediatric Nurse Practitioner | Festus, MO |
| 1114478120 | Sean Rudolph | Individual | Athletic Trainer | Festus, MO |
| 1477063253 | Ashley Reese | Individual | Critical Care Pediatric Nurse Practitioner | Festus, MO |
| 1013568120 | Blair Theis | Individual | Pediatric Nurse Practitioner | Festus, MO |
| 1467327114 | Morgan Korder | Individual | Pediatric Nurse Practitioner | Festus, MO |
Verify this record
Cross-check NPI 1861477085 against the authoritative CMS record: view Daniel Gerrit Rudolph on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-09-21.