Michael Robert Ruttle, P.A

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA00723 Issued in TX

Practice address

2507 Lake Rd # 2
Huntsville, TX 77340-5735

Phone

(936) 291-3219

Fax

(936) 291-7206

NPI assigned

Mar 29, 2007

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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Walker County Hospital Corporation

  • Rural Health Clinic/Center
  • Coldspring, TX
  • NPI 1003291915
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801916556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18335 DOGWOOD DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773033217",
            "telephone_number": "936-291-3219",
            "fax_number": "936-291-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 LAKE RD # 2",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773405735",
            "telephone_number": "936-291-3219",
            "fax_number": "936-291-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTTLE",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA00723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Nicole Rose
• Mary Rosenquist, D.O.
• Melissa Ross, OTR
• Paul David Ruffner, RPH
• Norman Thomas Rushing, D.D.S.
• Amanda Cathryn Sachs, DC
• Sacred Seniors
• Sam Houston Cancer Center LP
• Sam Houston Emergency Center LLC (Physicians ER Huntsville)
• Sam Houston State University

• Medical Physician Assistant in Huntsville, TX
• Providers in Huntsville, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.