Active NPI
Clara Rutledge
- Counselor
- Durant, OK
National Provider Identifier
1083070395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 324 N Washington Ave
Durant, OK 74701-3642 - Phone
- (580) 931-3008
- NPI assigned
- Jan 4, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
324 N Washington Ave
Durant, OK 74701-3642
Mailing address
115 Glenbrook Dr
Calera, OK 74730-5516
Phone (843) 509-2759
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100728830 | Medicaid | OK |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1083070395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 GLENBROOK DR",
"city": "CALERA",
"state": "OK",
"postal_code": "747305516",
"telephone_number": "843-509-2759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 N WASHINGTON AVE",
"city": "DURANT",
"state": "OK",
"postal_code": "747013642",
"telephone_number": "580-931-3008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTLEDGE",
"first_name": "CLARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-04",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100728830",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.