Active NPI
Charles David Rutledge, M.D.
- Specialist
- Knoxville, TN
National Provider Identifier
1487623971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD18985
- Practice address
- 4711 Centerline Dr
Suite 100
Knoxville, TN 37917-1403 - Phone
- (865) 545-8700
- Fax
- (865) 545-8704
- NPI assigned
- Mar 16, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MD18985 | TN | Primary |
Addresses
Primary practice location
4711 Centerline Dr
Suite 100
Knoxville, TN 37917-1403
Mailing address
4711 Centerline Dr
Suite 100
Knoxville, TN 37917-1403
Phone (865) 545-8700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18985 | Medicaid | TN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD18985 | TN | MD | Specialist |
| 18985 | TN | MD | Critical Care Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Dynamics Inc | Past | Accepting new patients | |
| Medical Education Assistance Corporation | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325203200000",
"number": "1487623971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4711 CENTERLINE DR",
"address_2": "SUITE 100",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379171403",
"telephone_number": "865-545-8700",
"fax_number": "865-545-8704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4711 CENTERLINE DR",
"address_2": "SUITE 100",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379171403",
"telephone_number": "865-545-8700",
"fax_number": "865-545-8704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTLEDGE",
"first_name": "CHARLES",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-16",
"last_updated": "2011-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TN",
"license": "MD18985",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "18985",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.