Kelsey Rutherford, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1977 Issued in OK

Practice address

2221 W Detroit St
Broken Arrow, OK 74012-3628

Phone

(918) 615-6492

NPI assigned

Aug 20, 2015

Sex

Female

Sole proprietor

No

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 OK

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  Occupational Therapist, OK

  Medicare reassignment Care Compare group NPD
• Collaborative Therapy Services Inc

  • Multi-Specialty Clinic/Center
  • Broken Arrow, OK
  • NPI 1932344835
  NPD (past)

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1275909616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 E 2ND ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741121316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 W DETROIT ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123628",
            "telephone_number": "918-615-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "KELSEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "1977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lanette Kaye Russell, LPC
• Linda J. Russell, LPC
• Lyan Russell, PHARMD
• Donna Rust, LCSW
• Caleb Paul Ruth
• Matthew Aaron Ruyle, COTA
• Jacob Austin Ruzicka, MD
• S-Q Home Care Specialties Inc
• S-Q Residential Services
• Kristi Gene Sager, ARNP

• Occupational Therapist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Occupational Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.