Individual provider Active NPI

Abigail Ellen Rutledge, AT, ATC, LAT

  • Athletic Trainer
  • Holt, MI
National Provider Identifier
1922890342
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2601003122 Issued in MI
Practice address
5713 Harper Rd
Holt, MI 48842-8616
Phone
(517) 512-0308
NPI assigned
May 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2601003122 MI Primary

Addresses

Primary practice location

5713 Harper Rd
Holt, MI 48842-8616

Mailing address

5713 Harper Rd
Holt, MI 48842-8616
Phone (517) 512-0308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2601003122MIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1922890342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5713 HARPER RD",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488428616",
            "telephone_number": "517-512-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5713 HARPER RD",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488428616",
            "telephone_number": "517-512-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "ABIGAIL",
        "middle_name": "ELLEN",
        "credential": "AT, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601003122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holt, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.