Peggy A Rutman, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24127 Issued in MN

Practice address

318 East Main Street
Centeral Lakes Medical Clinic, P.a.
Crosby, MN 56441-1645

Phone

(218) 546-8375

Fax

(218) 546-4400

NPI assigned

Oct 4, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1780770230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 EAST MAIN STREET",
            "address_2": "CENTERAL LAKES MEDICAL CLINIC, P.A.",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411645",
            "telephone_number": "218-546-8375",
            "fax_number": "218-546-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 EAST MAIN STREET",
            "address_2": "CENTERAL LAKES MEDICAL CLINIC, P.A.",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411645",
            "telephone_number": "218-546-8375",
            "fax_number": "218-546-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTMAN",
        "first_name": "PEGGY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "24127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "434800100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Lee Rosenbaum, MD
• Staci Ranae Roslansky, APRN,CNP
• Brittany Roy, CRNA
• Lacey Marie Runninghawk Stawarski, MD
• Atlantis Dawn Russ, MD
• Colin Patrick Ryan, APRN, CRNA
• S Sjoberg PLC (Great River Eye Clinic)
• Katelyn Sarlette, PA-C
• Regina L Schimek, RD
• Gina N Schlueter, MD

• Family Medicine Physician in Crosby, MN
• Providers in Crosby, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.