Russell Ray Rutledge III

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A-0959 Issued in NM

Practice address

3615 Highway 528 NW Ste 106
Albuquerque, NM 87114-8919

Phone

(505) 899-4334

Fax

(505) 792-4236

NPI assigned

Apr 9, 2014

Last updated

Apr 9, 2014By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Integrated Wellness

  • Multi-Specialty Clinic/Center
  • Albuquerque, NM
  • NPI 1063788701
  NPD (past)
• Integrated Wellness

  • Physical Therapy Assistant
  • Albuquerque, NM
  • NPI 1285053918
  NPD (past)

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1700205432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 HIGHWAY 528 NW STE 106",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871148919",
            "telephone_number": "505-899-4334",
            "fax_number": "505-792-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 HIGHWAY 528 NW STE 106",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871148919",
            "telephone_number": "505-899-4334",
            "fax_number": "505-792-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "RUSSELL",
        "middle_name": "RAY",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "A-0959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO PHYSICAL THERAPY BOARD",
            "identifier": "A-0959",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Russell Rutherford
• Michelle M Ruthmann, PA-C
• Lindsay Ann Rutland, MS, LMHC
• Joan Rutledge, MD
• Rachel Rutledge
• Teresa L Rutledge, MD
• Tsitsi Thamar Rutsito
• Kelley Rutter, PA-C
• Adrien Ruvalcaba
• Kimberly Ruvalcaba

• Physical Therapy Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physical Therapy Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.