Kyle Rutledge, D.O., PH.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO210542 Issued in OR

Practice address

730 Biddle Rd
Medford, OR 97504-6116

Phone

(541) 535-6239

NPI assigned

Apr 14, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Psychiatry

Education

Western Un of HLTH Sciences, Col of Podiatric Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krutledge598200@direct.ochin.org

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.

• Asante Physician Partners

  • Family Medicine Physician
  • Medford, OR
  • NPI 1922381326

  Psychiatry

  Medicare reassignment Care Compare group NPD
• La Clinica del Valle Family Health Care Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Medford, OR
  • NPI 1851327571
  Medicare reassignment NPD
• La Clinica del Valle Family Health Care Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Medford, OR
  • NPI 1679896278
  NPD

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1265828446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 BIDDLE RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046116",
            "telephone_number": "541-535-6239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Houghton Ave",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486025303",
            "country_code": "US",
            "telephone_number": "989-583-6800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "691 Murphy Rd",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975044346",
            "country_code": "US",
            "telephone_number": "541-789-4078",
            "fax_number": "541-789-3037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "KYLE",
        "credential": "D.O., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101023280",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101025230",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "DO210542",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "DO210542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Paul Russell
• Amber Russo
• Betzy Russo, LMT
• Darcie Raina Russo, RDH
• Tina Rutar, M.D.
• Tasha Renee Rutledge, CPNP-PO
• Makayla Yoshimoto Ruzi, OTR/L
• Ronald Anthony Ruzicka, SLP
• Bonita Annette Ryall, N.P.
• Brittany Ryan, MASSAGE THERAPIST

• Psychiatry Physician in Medford, OR
• Providers in Medford, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.