Active NPI
Amy R Rutenberg, PHD
- Clinical Psychologist
- Lexington, KY
National Provider Identifier
1396038394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 964
- Practice address
- 1351 Newtown Pike
Lexington, KY 40511-1275 - Phone
- (859) 253-1686
- NPI assigned
- May 24, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 964 | KY | Primary |
Addresses
Primary practice location
1351 Newtown Pike
Lexington, KY 40511-1275
Mailing address
1351 Newtown Pike
Lexington, KY 40511-1275
Phone (859) 253-1686
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731081 | Medicaid | KY |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 964 | KY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306195200000",
"number": "1396038394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1351 NEWTOWN PIKE",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405111275",
"telephone_number": "859-253-1686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1351 NEWTOWN PIKE",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405111275",
"telephone_number": "859-253-1686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTENBERG",
"first_name": "AMY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-24",
"last_updated": "2011-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KY",
"license": "964",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1790731081",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.