Kellie Anne Rutherford, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

0024176699 Issued in VA

Practice address

5955 Harbour Park Dr
Midlothian, VA 23112-2163

Phone

(804) 744-4495

NPI assigned

Oct 24, 2018

Last updated

Aug 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15869/brand/1/csg/1/fhir/r4

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.

• Chesterfield Pediatrics

  • Clinic/Center
  • Midlothian, VA
  • NPI 1932286903
  NPD
• Henrico Pediatrics, P.C.

  • Pediatric Adolescent Medicine Physician
  • Richmond, VA
  • NPI 1104906841
  NPD (past)
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD (past)

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1679049092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-744-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-744-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "KELLIE",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024176699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Mosher, DDS, PC
• Russell N Mosher DDS PC
• Denisha Russell, BEHAVIOR TECHNICIAN
• Patrick Russo, PT
• Heather Grace Ruth, R.D.
• Rva Academy
• Rva Direct Wellness
• Rva Skin Well PLLC (Midlothian Dermatology)
• Rva Therapeutic Counseling PLC
• Cynthia Shiloh Ryan, MD

• Pediatric Nurse Practitioner in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Pediatric Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.