Active NPI
Jasmine Rutherford, PSY.D.
- Clinical Psychologist
- Chapin, SC
National Provider Identifier
1356728992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1350
- Practice address
- 2101 Dutch Fork Rd
Chapin, SC 29036-7576 - Phone
- (910) 742-9243
- Fax
- (888) 746-1787
- NPI assigned
- May 4, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY003814 | GA | |
| Clinical Psychologist | 103TC0700X | 1350 | SC | Primary |
Addresses
Primary practice location
2101 Dutch Fork Rd
Chapin, SC 29036-7576
Mailing address
PO Box 538622
Atlanta, GA 30353-8622
Phone (910) 742-9243
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 |
|---|---|---|---|
| PSY003814 | GA | MD | Clinical Psychologist |
| 1350 | SC | MD | Critical Care Neonatal Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433289600000",
"number": "1356728992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 538622",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303538622",
"telephone_number": "910-742-9243",
"fax_number": "888-746-1787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 DUTCH FORK RD",
"city": "CHAPIN",
"state": "SC",
"postal_code": "290367576",
"telephone_number": "910-742-9243",
"fax_number": "888-746-1787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTHERFORD",
"first_name": "JASMINE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-04",
"last_updated": "2015-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY003814",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "1350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chapin, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.