Individual provider Active NPI

Travis J Rutland, MD

  • Gastroenterology Physician
  • Dothan, AL
National Provider Identifier
1518922087
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
26249 Issued in AL
Practice address
480 Honeysuckle Rd
Dothan, AL 36305-1156
Phone
(334) 836-1212
Fax
(334) 836-1888
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 26249 AL Primary

Addresses

Primary practice location

480 Honeysuckle Rd
Dothan, AL 36305-1156

Mailing address

480 Honeysuckle Rd
Dothan, AL 36305-1156
Phone (334) 836-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20041213000779 AL Practitioner - GastroenterologyPractitioner - Internal Medicine 6709843642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of South Alabama College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gut PCGroup PAC ID 3375589799, 53 clinicians

Practice addresses (Care Compare)

480 Honeysuckle Rd
Dothan, AL 36305-1156
Phone (334) 836-1212

614 N Main St
Suite a
Enterprise, AL 36330-1775
Phone (334) 489-4244

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy415
Upper gastrointestinal (GI) endoscopy for acid reflux817

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26249ALMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gut PC Gastroenterology CurrentSince Aug 3, 2009 Accepting new patients
Gut PC CurrentSince Aug 1, 2009 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Mobile Emergency Group PC Past Accepting new patients

Locations

265 Medical Park Blvd
Dothan, AL 36301
Phone (334) 305-0112

480 Honeysuckle Rd
Dothan, AL 36305
Phone (334) 792-6933

614 N Main St
Ste A
Enterprise, AL 36330
Phone (334) 489-4244

Interoperability endpoints

  • Direct secure messaging: trutland14450@southeasthealth.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1518922087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 HONEYSUCKLE RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051156",
            "telephone_number": "334-836-1212",
            "fax_number": "334-836-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 HONEYSUCKLE RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051156",
            "telephone_number": "334-836-1212",
            "fax_number": "334-836-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLAND",
        "first_name": "TRAVIS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AL",
            "license": "26249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.