Individual provider Active NPI

Mary T Rutledge, MSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1447210588
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004529 Issued in NC
Practice address
8601 University East Dr
Charlotte, NC 28213-4353
Phone
(704) 597-3500
Fax
(704) 597-3579
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C004529 NC Primary

Addresses

Primary practice location

8601 University East Dr
Charlotte, NC 28213-4353

Mailing address

8601 University East Dr
Charlotte, NC 28213-4353
Phone (704) 597-3500

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

State licenses

LicenseStateTypeSpecialty
C004529NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1447210588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 UNIVERSITY EAST DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282134353",
            "telephone_number": "704-597-3500",
            "fax_number": "704-597-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 UNIVERSITY EAST DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282134353",
            "telephone_number": "704-597-3500",
            "fax_number": "704-597-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "MARY",
        "middle_name": "T",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.

Verify at the official NPI Registry.