Jordan Rutherford, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

42434 Issued in AL

Practice address

421 W College St
Florence, AL 35630-5520

Phone

(256) 764-9522

Fax

(256) 764-1139

NPI assigned

Mar 26, 2017

Last updated

Feb 22, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Infants and Childrens Clinic PC

  • Pediatrics Physician
  • Florence, AL
  • NPI 1689685315
  NPD (past)
• RCHP - Florence LLC

  dba North Alabama Medical Center

  • General Acute Care Hospital
  • Florence, AL
  • NPI 1477874337
  NPD (past)

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

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1518498054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 W COLLEGE STREET",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "35630",
            "telephone_number": "256-764-9522",
            "fax_number": "256-764-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W COLLEGE ST",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305520",
            "telephone_number": "256-764-9522",
            "fax_number": "256-764-1139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "449 W 23rd St",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324054507",
            "country_code": "US",
            "telephone_number": "850-769-8341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "528 W Baldwin Rd Unit A",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324053313",
            "country_code": "US",
            "telephone_number": "850-522-1522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "JORDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-26",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME143517",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "T-3420",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "42434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "1518498054",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265009",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Anne Rudd, DNAP
• Rural Health Clinics LLC (Bowling Family Medical Clinic - Florence)
• Russ Dentistry
• Christian Russ
• Emily Katherine Russell, CRNP
• Safeplace, Inc.
• Katelin Saint, FNP-C
• Sabrina Samano, OTR/L
• Samuel Louis Kirby (Drs Kirby and McLaughlin)
• Susana Sanchez Guzman, M.D

• Pediatrics Physician in Florence, AL
• Providers in Florence, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.