Active NPI
Lonnie Douglas Rutherford, LADC
- Case Manager/Care Coordinator
- Perry, OK
National Provider Identifier
1497941439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 323
- Practice address
- 102 E Fir St
Perry, OK 73077-4900 - Phone
- (580) 762-7561
- Fax
- (580) 762-2576
- NPI assigned
- Sep 24, 2007
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 323 | OK | Primary |
Addresses
Primary practice location
102 E Fir St
Perry, OK 73077-4900
Mailing address
102 E Fir St
Perry, OK 73077-4900
Phone (580) 762-7561
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
| License | State | Type | Specialty |
|---|---|---|---|
| 323 | OK | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190592000000",
"number": "1497941439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 E FIR ST",
"city": "PERRY",
"state": "OK",
"postal_code": "730774900",
"telephone_number": "580-762-7561",
"fax_number": "580-762-2576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 E FIR ST",
"city": "PERRY",
"state": "OK",
"postal_code": "730774900",
"telephone_number": "580-762-7561",
"fax_number": "580-762-2576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTHERFORD",
"first_name": "LONNIE",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-24",
"last_updated": "2007-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OK",
"license": "323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perry, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.