NPIMap

Organization Active NPI

Rutherford Emergency Medicine PA

  • Emergency Medicine Physician
  • Rutherfordton, NC
National Provider Identifier
1700801636
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
N/A Issued in NC
Legal business name
RUTHERFORD EMERGENCY MEDICINE PA
Practice address
288 S Ridgecrest Ave
Rutherfordton, NC 28139-2838
Phone
(843) 237-3378
Fax
(843) 237-5073
NPI assigned
Jul 13, 2006
Last updated
Mar 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Authorized official

Name
Mike Brady
Title
Administrator for Group
Phone
(828) 277-7772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X N/A NC Primary

Addresses

Primary practice location

288 S Ridgecrest Ave
Rutherfordton, NC 28139-2838

Mailing address

PO Box 75358
Charlotte, NC 28275-0358
Phone (843) 237-3378

Other identifiers 3

IdentifierTypeStateIssuer
CH4865OtherNCRAILROAD MEDICARE
011R2OtherNCBLUE CROSS BLUE SHIELD
89011R2MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1700801636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75358",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282750358",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 S RIDGECREST AVE",
            "city": "RUTHERFORDTON",
            "state": "NC",
            "postal_code": "281392838",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTHERFORD EMERGENCY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "ADMINISTRATOR FOR GROUP",
        "authorized_official_telephone_number": "828-277-7772"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH4865",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "011R2",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011R2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutherfordton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; 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.