Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. THOMAS FRANKLIN RUTHERFORD III DO
NPI 1225527138
Hospitalist in Decatur, IL

Q: What is Thomas Rutherford's NPI number?

The NPI number for Thomas Rutherford is 1225527138. It was assigned to this individual provider in the NPPES registry on May 7, 2018.

Q: What is Thomas Rutherford's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Rutherford was last updated on July 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 07, 2018PECOS Enrolled

94.61/100

CMS Quality Rating

176 W MOUND RD, DECATUR, IL 62526(217) 875-0163 Get Directions Write a Review

NPPES record last updated: July 20, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 20, 2026, Aug 1, 2024, Jul 10, 2023 and 1 more (4 updates tracked since 2018).

On this page

About Dr. Thomas Franklin Rutherford Iii Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THOMAS FRANKLIN RUTHERFORD III DO (NPI 1225527138) is an individual hospitalist provider in Decatur, Illinois, licensed in Illinois (036165379) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS, is affiliated with St Anthonys Memorial Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1225527138

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameDR. THOMAS FRANKLIN RUTHERFORD IIICredential: DO

Location Address176 W MOUND RDDecatur, IL 62526-1964

Mailing Address176 W Mound RdDecatur, IL 62526-1964 · (217) 875-0163

Phone(217) 875-0163

Sole ProprietorYes

Medical School CMSLiberty Univ College Of Osteopathic MedicineGraduated 2018

Enumeration DateMay 7, 2018

Last NPPES UpdateJuly 20, 20264 updates tracked since enumeration

NPPES CertifiedJuly 20, 2026

✔ NPI 1225527138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in IL · 036165379

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License 312615 (LA), 036-165379 (IL)

Also ListedPediatricsTaxonomy 208000000X · License 036-165379 (IL), 312615 (LA)

176 W MOUND RD, Decatur, IL 62526

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Secondary Practice Locations 3

Location 1401 Matthew Street, Emergency DepartmentMarietta, OH 45750 · Phone (740) 568-5669

Location 21501 Kings HwyShreveport, LA 71103-4228 · Phone (318) 675-5915

Location 31004 Health Center Dr Ste 201Mattoon, IL 61938-4605 · Phone (217) 238-4961

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Thomas Franklin Rutherford Iii Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739419490

PECOS Enrollment IDI20230725001291

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

291 services154 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

171 services111 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

109 services79 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

87 services58 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

34 services34 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

28 services28 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Anthonys Memorial Hospital

Acute Care Hospitals · Effingham, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140032

Location503 N Maple StreetEffingham, IL 62401 · Effingham County

Emergency services Birthing friendly

St Johns Hospital

Acute Care Hospitals · Springfield, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140053

Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County

Emergency services Birthing friendly

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140135

Location2300 North Edward StreetDecatur, IL 62526 · Macon County

Emergency services Birthing friendly

St Marys Hospital

Acute Care Hospitals · Decatur, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140166

Location1800 E Lake Shore DrDecatur, IL 62521 · Macon County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62526 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.61/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

85.17

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JADE BOLLINGER APRN

Nurse Practitioner