The Rutherford Medical Clinic Llc is a medicare enrolled primary clinic (Nurse Practitioner - Family) in Rutherford, Tennessee. The current practice location for The Rutherford Medical Clinic Llc is 104 E Main St, Rutherford, Tennessee. For appointments, you can reach them via phone at
(731) 665-7741. The mailing address for The Rutherford Medical Clinic Llc is Po Box 370, Rutherford, Tennessee and phone number is (731) 665-7741.
The Rutherford Medical Clinic Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1972772242. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(731) 665-7741.
Primary Care Clinic Profile
| Full Name | The Rutherford Medical Clinic Llc |
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| Speciality | Nurse Practitioner |
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| Location | 104 E Main St, Rutherford, Tennessee |
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| Authorized Official Name and Position | Russell E Little (PROVIDER/OWNER) |
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| Authorized Official Contact | 7316657741 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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The Rutherford Medical Clinic Llc
Po Box 370
Rutherford
TN 38369-0370
Ph: (731) 665-7741 | The Rutherford Medical Clinic Llc
104 E Main St
Rutherford
TN 38369-9711
Ph: (731) 665-7741 |
NPI Details:
| NPI Number | 1972772242 |
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| Provider Enumeration Date | 02/20/2008 |
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| Last Update Date | 08/05/2019 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 2668550211 |
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| Medicare Enrollment ID | O20080422000712 |
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Medical Identifiers
Medical identifiers for The Rutherford Medical Clinic Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1972772242 | NPI | - | NPPES |
| 5442152 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
The Rutherford Medical Clinic Llc acts as a billing entity for following providers:
| Provider Name | Russell E Little |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1962456061
PECOS PAC ID: 5890773477
Enrollment ID: I20040709001199 |
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