Individual provider Active NPI

Natessa Ramey Rutherford, FNP

  • Nurse Practitioner
  • Mount Airy, NC
National Provider Identifier
1992290654
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5019422 Issued in NC
Practice address
2133 Rockford St Ste 1400
Mount Airy, NC 27030-6594
Phone
(336) 673-6560
Fax
(336) 719-0494
NPI assigned
Jun 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5019422 NC Primary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 0001251526 VA

Addresses

Primary practice location

2133 Rockford St Ste 1400
Mount Airy, NC 27030-6594

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1650 Hwy 18 South
Sparta, NC 28675
Phone (336) 372-4095

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240214003937 NC Practitioner - Nurse Practitioner 0547604878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0001251526VAMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. CurrentSince Feb 25, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 25, 2024 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Feb 25, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 25, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

865 Westlake Dr
Mount Airy, NC 27030
Phone (336) 719-6100

2133 Rockford St
Ste 1400
Mount Airy, NC 27030
Phone (336) 673-6560

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: nrutherford887570@direct.novanthealth.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1992290654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 ROCKFORD ST STE 1400",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270306594",
            "telephone_number": "336-673-6560",
            "fax_number": "336-719-0494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Hwy 18 South",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "NC",
            "postal_code": "28675",
            "country_code": "US",
            "telephone_number": "336-372-4095",
            "fax_number": "336-372-2722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "NATESSA",
        "middle_name": "RAMEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5019422",
            "primary": true
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "VA",
            "license": "0001251526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.