Individual provider Active NPI

Charles Anthony Rutledge, MD

  • Internal Medicine Physician
  • Cullman, AL
National Provider Identifier
1295780310
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10898 Issued in AL
Practice address
1890 Al Highway 157
Suite 300
Cullman, AL 35058-3601
Phone
(256) 737-8000
Fax
(256) 737-8058
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10898 AL Primary

Addresses

Primary practice location

1890 Al Highway 157
Suite 300
Cullman, AL 35058-3601

Mailing address

1890 Al Highway 157
Cullman, AL 35058-3601
Phone (256) 737-8000

Other identifiers 3

IdentifierTypeStateIssuer
051012058OtherALBLUE CROSS BLUE SHIELD AL
000012058MedicaidAL
10033435OtherALRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20060208000778 AL Practitioner - Internal Medicine 1951316132 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10898ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cullman Internal Medicine, PC Internal Medicine CurrentSince Jul 12, 1999 Accepting new patients
Cullman Regional Medical Center, Inc Current Accepting new patients
Cullman Regional Medical Center, Inc CurrentSince Jan 13, 2006 Accepting new patients
Cullman Regional Medical Center, Inc CurrentSince Jan 13, 2006 Accepting new patients

Locations

1705 Main Ave SW
Ste B
Cullman, AL 35055
Phone (256) 735-5075

1890 AL Highway 157
Ste 300
Cullman, AL 35058
Phone (256) 737-2100

1912 AL Highway 157
Cullman, AL 35058
Phone (256) 737-2496

1890 AL Highway 157
Cullman, AL 35058
Phone (256) 737-8000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1295780310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350583601",
            "telephone_number": "256-737-8000",
            "fax_number": "256-737-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 AL HIGHWAY 157",
            "address_2": "SUITE 300",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350583601",
            "telephone_number": "256-737-8000",
            "fax_number": "256-737-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "10898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AL",
            "identifier": "051012058",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000012058",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "10033435",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.