Ronald Bruce Rutherford, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

850 Ticonderoga St Ste 110
Pearl Harbor, HI 96860-4460

Phone

(808) 473-2798

NPI assigned

Oct 18, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1750691291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 TICONDEROGA ST STE 110",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "968604460",
            "telephone_number": "808-473-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 TICONDEROGA ST STE 110",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "968604460",
            "telephone_number": "808-473-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "RONALD",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert Rotruck, MD
• Shannan Rotruck, CRNA
• Bridget Rountree, RN, BSN
• Lisa Irene Roush, RN
• Nicole Boshnakov Ruh, MD/MBA
• Elizabeth Gail Sabau, RN
• Jonathan Paul Sacks, PHYSICIAN ASSISTANT
• Emmie Saigusa, PHARM.D.
• Erin Sakuda
• Cynthia Joyce Bullock Santos, RN

• Independent Duty Corpsman in Pearl Harbor, HI
• Providers in Pearl Harbor, HI by specialty
• Independent Duty Corpsman in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.