Active NPI
David Allan Rutter, R.N.
- Home Health Registered Nurse
- Stockton, CA
National Provider Identifier
1013110428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 425261
- Practice address
- 1588 E March LN
Stockton, CA 95210-5669 - Phone
- (207) 474-7881
- Fax
- (913) 814-4525
- NPI assigned
- Jun 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 425261 | CA | |
| Home Health Registered Nurse | 163WH0200X | 425261 | CA | Primary |
Addresses
Primary practice location
1588 E March LN
Stockton, CA 95210-5669
Mailing address
235 Sterling Grove Dr
Galt, CA 95632-2433
Phone (209) 712-0661
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 425261 | CA | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1013110428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 STERLING GROVE DR",
"city": "GALT",
"state": "CA",
"postal_code": "956322433",
"telephone_number": "209-712-0661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1588 E MARCH LN",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952105669",
"telephone_number": "207-474-7881",
"fax_number": "913-814-4525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTTER",
"first_name": "DAVID",
"middle_name": "ALLAN",
"name_prefix": "Mr.",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-06",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "425261",
"primary": false
},
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "CA",
"license": "425261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.