NPIMap

Organization Active NPI

Rutledge Skin Care Clinic, PA

  • Primary Care Clinic/Center
  • Aztec, NM
National Provider Identifier
1285741652
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
95-338 Issued in NM
Legal business name
RUTLEDGE SKIN CARE CLINIC, PA
Practice address
4 Road 3641
Aztec, NM 87410-9562
Phone
(505) 564-8300
Fax
(505) 564-8303
NPI assigned
Aug 23, 2006
Last updated
Jul 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Authorized official

Name
Michael Joseph Rutledge, MDNPI 1568575314
Title
Owner
Phone
(505) 564-8300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 95-338 NM Primary

Addresses

Primary practice location

4 Road 3641
Aztec, NM 87410-9562

Mailing address

4801 N Butler Ave
Suite 13101
Farmington, NM 87401-6002
Phone (505) 564-8300

National Provider Directory

National Provider Directory

Locations

4 Road 3641
Aztec, NM 87410
Phone (505) 564-8300

4801 N Butler Ave
Ste 13-101
Farmington, NM 87401
Phone (505) 564-8300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594339200000",
    "number": "1285741652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 N BUTLER AVE",
            "address_2": "SUITE 13101",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016002",
            "telephone_number": "505-564-8300",
            "fax_number": "505-564-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ROAD 3641",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874109562",
            "telephone_number": "505-564-8300",
            "fax_number": "505-564-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTLEDGE SKIN CARE CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A",
        "authorized_official_last_name": "RUTLEDGE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-564-8300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NM",
            "license": "95-338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aztec, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.