The Rutherford Medical Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

THE RUTHERFORD MEDICAL CLINIC LLC

Practice address

104 E Main St
Rutherford, TN 38369-9711

Phone

(731) 665-7741

Fax

(731) 665-7750

NPI assigned

Feb 20, 2008

Last updated

Aug 5, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Russell E Little, FNPNPI 1962456061

Title

Provider/Owner

Phone

(731) 665-7741

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972772242. Details of each certification follow.

• CCN 883803 Rural health clinic · Active · Details

Rural health clinic certification: CCN 883803

Legal name

THE RUTHERFORD MEDICAL CLINIC LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Apr 4, 2019

Last certification

Mar 30, 2026

Ownership / control type

1B

Organization structure

LLCProprietary

Enrollment address

104 East Main Street
Rutherford, TN 38369-9711

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Russell E Little, APN

  • Family Nurse Practitioner
  • Rutherford, TN
  • NPI 1962456061

  5% Or Greater Direct Ownership Interest

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Russell E Little, APN

  • Family Nurse Practitioner
  • Rutherford, TN
  • NPI 1962456061
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564963200000",
    "number": "1972772242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "RUTHERFORD",
            "state": "TN",
            "postal_code": "383690370",
            "telephone_number": "731-665-7741",
            "fax_number": "731-665-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E MAIN ST",
            "city": "RUTHERFORD",
            "state": "TN",
            "postal_code": "383699711",
            "telephone_number": "731-665-7741",
            "fax_number": "731-665-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RUTHERFORD MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2019-08-05",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "731-665-7741",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5442152",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bill H Hester, D.PH
• Russell E Little, APN
• Candace Clanton McCaig, PHARM D.
• Thomas Nelson, M.D.
• Casey Oliver, PHARMD
• Thomas H Nelson MD
• Bethany Turner, PTA

• Family Nurse Practitioner in Rutherford, TN
• Providers in Rutherford, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.