Kristie Lynn Blair-Rutherford, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5004405 Issued in NC

Practice address

1718 E 4TH St Ste 105
Charlotte, NC 28204-3193

Phone

(704) 384-7292

Fax

(704) 384-8880

NPI assigned

Feb 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Heart Care of Charlotte, LLCGroup PAC ID 7113225814, 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.

• Legacy Heart Care of Charlotte, LLC

  • Cardiovascular Disease Physician
  • Charlotte, NC
  • NPI 1467810663
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1831164383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10542 OLD BRASSLE DR",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282275802",
            "telephone_number": "980-207-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST STE 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043193",
            "telephone_number": "704-384-7292",
            "fax_number": "704-384-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR-RUTHERFORD",
        "first_name": "KRISTIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "RN1091690 ARNP4785P",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olive Bear Blackwood, LMFTA
• Bladder Behavior, PLLC
• Steve Blahitka, MA
• Ann Nicole Blaine-Coambs, DDS
• Blair Clinical Services PLLC
• Amber Marie Blair, PA
• Angela Michelle Blair, P.T.
• Jemarian Chantinel Blair
• Judith Blaise
• Blake Home Health Care LLC

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; 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.