Carolyn Michelle Davis Rutherford, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5516P Issued in KY

Practice address

3602 Cumberland Ave Ste B102
Middlesboro, KY 40965-2614

Phone

(606) 248-7778

Fax

(606) 248-7787

NPI assigned

Feb 20, 2008

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

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kentucky Friendly Care Center IncGroup PAC ID 0143572909, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kentucky Friendly Care Center, Inc.

  • Rural Health Clinic/Center
  • Middlesboro, KY
  • NPI 1467939066
  Medicare reassignment Care Compare group NPD
• Professional Family Healthcare Inc

  • Family Nurse Practitioner
  • Middlesboro, KY
  • NPI 1801120498
  NPD (past)
• Trinity Family Healthcare, PSC

  • Family Nurse Practitioner
  • Middlesboro, KY
  • NPI 1821001132
  NPD (past)

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1780852020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2898",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409654898",
            "telephone_number": "606-248-7778",
            "fax_number": "606-248-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 CUMBERLAND AVE STE B102",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652614",
            "telephone_number": "606-248-7778",
            "fax_number": "606-248-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "CAROLYN",
        "middle_name": "MICHELLE DAVIS",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "5516P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry B Roark, NP-C
• Leigh Shannon Roark, CCC-SLP
• Rogelio Uy, M.D., P.S.C.
• Joanie Roper
• James Rose
• Christina Sands, M.S.
• Jerebeth Glenae Saylor
• Shahzad Shahmalak, MD
• Leigh Anne Shumate, MS CCC-SLP
• Dustin Michael Simpson I, FNP

• Family Nurse Practitioner in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.