Active NPI
Kristine Rutledge
- Occupational Therapy Assistant
- Espanola, NM
National Provider Identifier
1710432547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3231
- Practice address
- 1260 Industrial Park Rd
Espanola, NM 87532-3503 - Phone
- (505) 367-3342
- NPI assigned
- Aug 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3231 | NM | Primary |
Addresses
Primary practice location
1260 Industrial Park Rd
Espanola, NM 87532-3503
Mailing address
2187 46TH St
Los Alamos, NM 87544-1720
Phone (505) 709-8143
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3231 | NM | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1710432547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2187 46TH ST",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875441720",
"telephone_number": "505-709-8143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 INDUSTRIAL PARK RD",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875323503",
"telephone_number": "505-367-3342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTLEDGE",
"first_name": "KRISTINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-22",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NM",
"license": "3231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.