Stacy Rutledge, FNP-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AP09966 Issued in LA

Practice address

5328 Cypress St
West Monroe, LA 71291-7506

Phone

(318) 396-3636

Fax

(318) 397-3639

NPI assigned

Jun 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Community Care Clinic LLC

  • Primary Care Clinic/Center
  • West Monroe, LA
  • NPI 1265671754
  Medicare reassignment NPD
• Calcasieu Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake Charles, LA
  • NPI 1467715490
  NPD (past)

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1174015002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5328 CYPRESS ST",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712917506",
            "telephone_number": "318-397-3636",
            "fax_number": "318-397-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5328 CYPRESS ST",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712917506",
            "telephone_number": "318-396-3636",
            "fax_number": "318-397-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "STACY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "AP09966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Ray Russell, DPT
• Debra Mae Russell, ACNPC, CCRN-CSC
• Michael Shane Russell, DC
• Edward Hampton Rutland, M.D.
• Roger Wayne Rutledge, FNP
• Lyndall Saadat, M.D.
• Salt & Light Aesthetics Inc
• Christopher H Salter, M.A.,LAC
• Samer N Roy MD LLC
• Samer N Roy, MD LLC

• Family Medicine Physician in West Monroe, LA
• Providers in West Monroe, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.