Individual provider Active NPI

Carrie L. Rutledge, FNP

  • Family Nurse Practitioner
  • Saint Robert, MO
National Provider Identifier
1992183511
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015007302 Issued in MO
Practice address
608 Old Route 66
Saint Robert, MO 65584-3730
Phone
(573) 336-5100
Fax
(573) 336-3118
NPI assigned
May 14, 2015
Last updated
Sep 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2015007302 MO Primary

Addresses

Primary practice location

608 Old Route 66
Saint Robert, MO 65584-3730

Mailing address

PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 820-2000

Other identifiers 1

IdentifierTypeStateIssuer
1992183511MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20150727000158 MO Practitioner - Nurse Practitioner 1153634720 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family CurrentSince Jun 22, 2015 Accepting new patients
Mercy Clinic East Communities Family CurrentSince Dec 21, 2015 Accepting new patients
Mercy Clinic East Communities CurrentSince Dec 21, 2015 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince Jun 22, 2015 Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

608 Old Route 66
Saint Robert, MO 65584
Phone (573) 336-5100

97 Saint Andrews Dr
Union, MO 63084
Phone (636) 583-2946

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

Interoperability endpoints

  • Direct secure messaging: crutledge705975@directb.mercy.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1992183511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505164",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505164",
            "telephone_number": "417-820-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 OLD ROUTE 66",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655843730",
            "telephone_number": "573-336-5100",
            "fax_number": "573-336-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "CARRIE",
        "middle_name": "L.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015007302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992183511",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Robert, MO

Sources for this page

Verify at the official NPI Registry.