Lorene Elaine Rutherford, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

39519 Issued in MN

Practice address

3000 Hundertmark Rd
Chaska, MN 55318-1150

Phone

(952) 556-0120

Fax

(952) 556-0121

NPI assigned

Nov 3, 2006

Last updated

Apr 11, 2024By the provider in NPPES

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 MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1821177502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 HUNDERTMARK RD",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181150",
            "telephone_number": "952-556-0120",
            "fax_number": "952-556-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HUNDERTMARK RD",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181150",
            "telephone_number": "952-556-0120",
            "fax_number": "952-556-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "LORENE",
        "middle_name": "ELAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "39519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Ross, PHARMD
• Maura Collins Ross, CNP
• Sarah Adele Roth, MSW, LICSW
• Brittney Royer
• Jenny Rebecca Ruoho, D.D.S.
• Ponciana W Sajulga, RN
• Michael Sala, LICSW
• Amal Samatar
• Marty Ray Sandvig
• Whitney Sue Sarnstrom, CNP

• Pediatrics Physician in Chaska, MN
• Providers in Chaska, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.