RUTLEDGE MEDICAL CLINIC INCORPORATED
NPI 1912191149
Internal Medicine in Rutledge, TN
About Rutledge Medical Clinic Incorporated NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RUTLEDGE MEDICAL CLINIC INCORPORATED (NPI 1912191149) is a healthcare organization registered as an internal medicine in Rutledge, Tennessee and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through August 19, 2027 and lists Mark E. Holland, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Rutledge Medical Clinic Incorporated is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Rutledge Medical Clinic Incorporated, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 44D0990290
Rutledge Medical Clinic · Rutledge, TNFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Rutledge Medical Clinic Incorporated's NPI number?
The NPI number for Rutledge Medical Clinic Incorporated is 1912191149. It was assigned to this organization in the NPPES registry on August 30, 2007.
Where is Rutledge Medical Clinic Incorporated located?
Rutledge Medical Clinic Incorporated is located at 8048 Rutledge Pike, Rutledge, TN 37861. The listed phone number is (865) 828-5243.
What is Rutledge Medical Clinic Incorporated's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Rutledge Medical Clinic Incorporated enrolled in Medicare?
Yes. Rutledge Medical Clinic Incorporated is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Rutledge Medical Clinic Incorporated?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Rutledge Medical Clinic Incorporated, in Internal Medicine and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Rutledge Medical Clinic Incorporated hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 44D0990290) is associated with this NPI, valid through August 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Rutledge Medical Clinic Incorporated was last updated on January 17, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.
# Rutledge Medical Clinic Incorporated · NPI 1912191149
Internal Medicine organization in Rutledge, Tennessee. Organization record, active in the CMS NPPES registry since August 30, 2007.
## Identity
- **NPI:** 1912191149 (Entity type: Organization)
- **Enumerated:** August 30, 2007
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Mark Holland, PRESIDENT
## Practice location
- **Address:** 8048 RUTLEDGE PIKE, Rutledge, TN 37861
- **Phone:** (865) 828-5243 · **Fax:** (865) 828-8678
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (1), Nurse Practitioner (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 17, 2008
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1912191149) · Data from the CMS NPPES public registry.