Individual provider Active NPI

Julie Jessica Bolin-Rutherford, CNP

  • Family Nurse Practitioner
  • Logan, OH
National Provider Identifier
1639741606
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0028537 Issued in OH
Practice address
601 State Route 664 N
Logan, OH 43138-8541
Phone
(740) 380-8171
NPI assigned
Jul 10, 2021
Last updated
Jan 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0028537 OH Primary

Addresses

Primary practice location

601 State Route 664 N
Logan, OH 43138-8541

Mailing address

PO Box 228
Logan, OH 43138-0228
Phone (740) 380-8171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210723002851 OH Practitioner - Nurse Practitioner 9830592146 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hocking Valley Medical Group, Inc.Group PAC ID 0345238622, 21 clinicians

Practice addresses (Care Compare)

601 State Route 664 N
Logan, OH 43138-8541
Phone (740) 380-8129

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hocking Valley Community Hospital Current Accepting new patients
Hocking Valley Medical Group Transportation CurrentSince Jun 1, 2023 Accepting new patients
Hocking Valley Medical Group, Inc. Single Specialty CurrentSince Jun 1, 2023 Accepting new patients
Lima Memorial Joint Operating Company Single Specialty Past Accepting new patients

Locations

601 State Route 664 N
Logan, OH 43138
Phone (740) 380-8000

819 State Route 664 N
Logan, OH 43138
Phone (740) 380-8140

819 State Route 664 N
Ste B
Logan, OH 43138
Phone (740) 380-8140

Interoperability endpoints

  • Direct secure messaging: jbolinrutherford1117958@direct.osumc.edu

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 2

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": "1625875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1639741606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431380228",
            "telephone_number": "740-380-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 STATE ROUTE 664 N",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431388541",
            "telephone_number": "740-380-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIN-RUTHERFORD",
        "first_name": "JULIE",
        "middle_name": "JESSICA",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-10",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0028537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, OH

Sources for this page

Verify at the official NPI Registry.