Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. John Bradley Rudolph, DO

Individual provider Family Medicine Physician · NPI 1548503022

Dr. John Bradley Rudolph, DO is a Family Practice in Lewiston, Idaho. Qualified in 2013, 13 years ago. Practices with St Joseph Hospital LLC, a 90-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Idaho and Washington.

Years since qualifying
13
Licensed in
ID, WA
In the registry since
2013
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

415 6th St Ste 3C
Lewiston, ID 83501-2431
Phone: (208) 750-7300
Fax: (208) 746-4899
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1119 Highland Ave, Clarkston, WA 99403-2836 — (509) 758-1450

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence O-0990 (ID)
Family Medicine Physician Taxonomy 207Q00000X · Licence OP60506022 (WA)

Record details

NPI number1548503022
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 3, 2013
Last updated in NPPESDecember 26, 2024
Certification dateDecember 26, 2024
Mailing address415 6th Street, Attn: Physician Services, Lewiston, ID 83501-2434

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Also practisesEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice St Joseph Hospital Llc — 90 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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