NPIMap

Individual provider Active NPI

William Martin Rutledge Jr., MD

  • Family Medicine Physician
  • Orange, TX
National Provider Identifier
1487761375
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F4463 Issued in TX
Practice address
610 Strickland Drive
Suite 200
Orange, TX 77630-4784
Phone
(409) 883-3201
Fax
(409) 883-3220
NPI assigned
Aug 24, 2006
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F4463 TX Primary

Addresses

Primary practice location

610 Strickland Drive
Suite 200
Orange, TX 77630-4784

Mailing address

610 Strickland Dr
Ste 200 C
Orange, TX 77630-4786
Phone (409) 883-3298

Other practice location 1

6901 Medical Center Dr Ste 220
Orange, TX 77630-1407
Phone (409) 883-3201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804000861 TX Practitioner - Family Practice 5395802193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

520 Douglas Blvd
Tyler, TX 75702-8307
Phone (903) 593-1721

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
F4463TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Dec 4, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 4, 2023 Accepting new patients
Orange Family Practice Associates Family Medicine Past Accepting new patients

Locations

6901 Medical Center Dr
Ste 220
Orange, TX 77630
Phone (409) 883-3201

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGFFCA/Endpoint/EGFFCA
  • Direct secure messaging: wrutledge345790@christushealth.direct-ci.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1487761375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 STRICKLAND DR",
            "address_2": "STE 200 C",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776304786",
            "telephone_number": "409-883-3298",
            "fax_number": "409-883-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 STRICKLAND DRIVE",
            "address_2": "SUITE 200",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776304784",
            "telephone_number": "409-883-3201",
            "fax_number": "409-883-3220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6901 Medical Center Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "TX",
            "postal_code": "776301407",
            "country_code": "US",
            "telephone_number": "409-883-3201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "WILLIAM",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F4463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, TX

Sources for this page

Verify at the official NPI Registry.