William Lyman Rutledge, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R3422 Issued in AR

Practice address

9712 W Markham St
Little Rock, AR 72205-2124

Phone

(501) 954-8800

Fax

(501) 954-8803

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Foundation: a Wellness Practice, LLC

  • Counselor
  • Jonesboro, AR
  • NPI 1750878203
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1003820036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5589",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720862124",
            "telephone_number": "501-661-8207",
            "fax_number": "501-661-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9712 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722052124",
            "telephone_number": "501-954-8800",
            "fax_number": "501-954-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "WILLIAM",
        "middle_name": "LYMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "R3422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105362001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Johnson Ruthven, LCSW
• Anita Ann Rutledge, LPC
• Ashley Rutledge, LPN
• Dominique Rutledge
• Estelle Alexis Rutledge, M.D.
• RWW Senior Living Outpatient Rehab Services LLC
• RX Moose Inc
• RX Moose Inc
• David Brent Ryals, M.D.
• Rickey Olvin Ryals

• Family Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.