Mallory Tucker Rutland

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN235650 Issued in GA

Practice address

506 Lee Blvd
Savannah, GA 31405-5448

Phone

(912) 856-3792

NPI assigned

Feb 28, 2019

Last updated

Feb 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mallory Elaine Tucker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mallory.rutland.2@8042.direct.athenahealth.com

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.

• Coastal Pediatrics, LLC

  dba Coastal Pediatrics

  • Pediatrics Physician
  • Pooler, GA
  • NPI 1659418077
  NPD (past)

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1700343423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 LEE BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055448",
            "telephone_number": "912-856-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 LEE BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055448",
            "telephone_number": "912-856-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLAND",
        "first_name": "MALLORY",
        "middle_name": "TUCKER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN235650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "TUCKER",
            "middle_name": "ELAINE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Phyllis Russell, LMT
• Robert Koji Russell, D.O.
• Lakeshia Ruth, RBT
• Linda Joy Rutherford, R.N.
• Annessa Rutkowski
• Rachael Ruttinger, MSN, APRN, WHNP-BC
• RX Inc (Lo Cost Pharmacy)
• RX, Inc (Lo Cost Pharmacy)
• Ryan Fann Prosthetics, LLC (Reform Prosthetics)
• Carly Ryan, M.D.

• Family Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.