Individual provider Active NPI

Robert Carver Rutherford, MD

  • Family Medicine Physician
  • Cloverdale, CA
National Provider Identifier
1699890988
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G75534 Issued in CA
Practice address
6 Tarman Dr
Cloverdale, CA 95425-3932
Phone
(707) 894-4229
Fax
(707) 894-2954
NPI assigned
Mar 19, 2007
Last updated
Jul 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X ME 49595 FL
Family Medicine Physician 207Q00000X G75534 CA Primary

Addresses

Primary practice location

6 Tarman Dr
Cloverdale, CA 95425-3932

Mailing address

100 W 3Rd St
Cloverdale, CA 95425-3204
Phone (707) 894-4229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 49595FLMDEmergency Medical Services (Emergency Medicine) Physician
G75534CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Health Care Authority of Lauderdale County and the City of Florenc Family Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1699890988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W 3RD ST",
            "city": "CLOVERDALE",
            "state": "CA",
            "postal_code": "954253204",
            "telephone_number": "707-894-4229",
            "fax_number": "707-894-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TARMAN DR",
            "city": "CLOVERDALE",
            "state": "CA",
            "postal_code": "954253932",
            "telephone_number": "707-894-4229",
            "fax_number": "707-894-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "ROBERT",
        "middle_name": "CARVER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "FL",
            "license": "ME 49595",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G75534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloverdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.