Jasmine Alishia Rutherford PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY003814 Issued in GA

Legal business name

JASMINE ALISHIA RUTHERFORD PSYD

Practice address

17 Felton PL
Suite a
Cartersville, GA 30120-2153

Phone

(770) 386-8996

Fax

(770) 386-8100

NPI assigned

Aug 6, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Maria Victoria McMickens

Title

Business Manager

Phone

(770) 386-8996

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1922417641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 FELTON PL",
            "address_2": "SUITE A",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202153",
            "telephone_number": "770-386-8996",
            "fax_number": "770-386-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 FELTON PL",
            "address_2": "SUITE A",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202153",
            "telephone_number": "770-386-8996",
            "fax_number": "770-386-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASMINE ALISHIA RUTHERFORD PSYD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A",
        "authorized_official_last_name": "MCMICKENS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "770-386-8996",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.