Carlie Savannah Payton-Rutledge, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7440 Issued in MS

Practice address

340 Highway 12 W
Kosciusko, MS 39090-3209

Phone

(662) 289-3588

Fax

(662) 289-3533

NPI assigned

Nov 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Medical Group of Mississippi LLCGroup PAC ID 8729973623, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carlie.payton-rutledge.1@27768.direct.athenahealth.com

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.

• Premier Medical Group of Mississippi LLC

  • Clinic/Center
  • Kosciusko, MS
  • NPI 1790827038
  Medicare reassignment Care Compare group NPD
• Premier Medical Group of Mississippi LLC

  • Clinic/Center
  • Jackson, MS
  • NPI 1548219884
  NPD (past)

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1487257515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23996",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253996",
            "telephone_number": "662-289-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 HIGHWAY 12 W",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903209",
            "telephone_number": "662-289-3588",
            "fax_number": "662-289-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYTON-RUTLEDGE",
        "first_name": "CARLIE",
        "middle_name": "SAVANNAH",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "7440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Reece Myers, DMD
• Laura Nabors
• Brenda Nail, FNP
• Newsouth Neurospine, LLC.
• Robert Hugh Patrick, RPH
• Jeffrey Scott Pearson
• Loren Pearson, PTA
• Robin Bryant Pee, LPC-S
• Whitney Moore Pettit, SPEECH THERAPIST
• Olivia Phillips

• Physical Therapist in Kosciusko, MS
• Providers in Kosciusko, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.