Active NPI
Larry G Rutledge, O.D.
- Optometrist
- Milford, OH
National Provider Identifier
1285707265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3266
- Practice address
- 1107 Allen Dr
Suite C
Milford, OH 45150-8763 - Phone
- (513) 965-2020
- Fax
- (513) 965-2025
- NPI assigned
- Nov 16, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3266 | OH | Primary |
Addresses
Primary practice location
1107 Allen Dr
Suite C
Milford, OH 45150-8763
Mailing address
1107 Allen Dr
Suite C
Milford, OH 45150-8763
Phone (513) 965-2020
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000011879 | Other | OH | BLUE CROSS & BLUE |
| 22-00925 | Other | UNITED HEALTHCARE | |
| 311157870004 | Other | MEDICAL MUTUAL | |
| 311157870 | Other | VSP | |
| 3266 | Other | HUMANA | |
| 32843 | Other | COORDINATED VISION CARE | |
| OH3266 | Other | EYEMED | |
| 311157870 | Other | CIGNA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3266 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285707265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 ALLEN DR",
"address_2": "SUITE C",
"city": "MILFORD",
"state": "OH",
"postal_code": "451508763",
"telephone_number": "513-965-2020",
"fax_number": "513-965-2025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 ALLEN DR",
"address_2": "SUITE C",
"city": "MILFORD",
"state": "OH",
"postal_code": "451508763",
"telephone_number": "513-965-2020",
"fax_number": "513-965-2025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTLEDGE",
"first_name": "LARRY",
"middle_name": "G",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "3266",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE",
"identifier": "000000011879",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "22-00925",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL MUTUAL",
"identifier": "311157870004",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VSP",
"identifier": "311157870",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "3266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COORDINATED VISION CARE",
"identifier": "32843",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "OH3266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "311157870",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Milford, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.