Active NPI
Ethan Brandon Rutledge, D.O.
- Pulmonary Disease Physician
- Cleveland, TN
National Provider Identifier
1508156696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 3169
- Practice address
- 110 Dunhill PL NW
Cleveland, TN 37311 - Phone
- (423) 476-2212
- NPI assigned
- Apr 11, 2011
- Last updated
- Jul 21, 2022
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Pulmonary Disease Physician | 207RP1001X | 3169 | TN | Primary |
| Hospitalist Physician | 208M00000X | 34.011041 | OH |
Addresses
Primary practice location
110 Dunhill PL NW
Cleveland, TN 37311
Mailing address
110 Dunhill PL NW
Cleveland, TN 37311-3866
Phone (423) 476-2212
Other practice location 1
5100 W Broad St
Columbus, OH 43228-1607
Phone (614) 544-2091
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
110 Dunhill Place NW
Cleveland, TN 37311-3883
Phone (423) 476-2212
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 23.66 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 78.88
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.011041 | OH | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Pulmonary Medicine, PC | Pulmonary Disease | Current | Accepting new patients |
| Blue Ridge Gastroenterology, PC | Past | Accepting new patients |
Locations
110 Dunhill Pl NW
Cleveland, TN 37311
Phone (423) 476-2212
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pulmonary Disease Physician
- Cleveland, TN
- NPI 1487601019
-
- Gastroenterology Physician
- Cleveland, TN
- NPI 1891801296
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Starr Regional Medical Center
- General Acute Care Hospital
- Athens, TN
- NPI 1669567319
-
- General Acute Care Hospital
- Cleveland, TN
- NPI 1255171096
-
dba Memorial Hospital Hixson
- General Acute Care Hospital
- Hixson, TN
- NPI 1083778633
-
dba Memorial Hospital
- General Acute Care Hospital
- Chattanooga, TN
- NPI 1255428736
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1508156696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 DUNHILL PL NW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373113866",
"telephone_number": "423-476-2212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 DUNHILL PL NW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "37311",
"telephone_number": "423-476-2212"
}
],
"practiceLocations": [
{
"address_1": "5100 W Broad St",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432281607",
"country_code": "US",
"telephone_number": "614-544-2091",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUTLEDGE",
"first_name": "ETHAN",
"middle_name": "BRANDON",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-11",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "TN",
"license": "3169",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "OH",
"license": "34.011041",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.