Kali Renee Rutherford, PA is a
Physician Assistant based in Jefferson Cty, Tennessee. Kali Renee Rutherford is licensed to practice in Tennessee (license number 5906) and her current practice location is
1405 S Sizer Ave Ste A, Jefferson Cty, Tennessee. She can be reached at her office (for appointments etc.) via phone at
(865) 690-3811.
NPI number for Kali Renee Rutherford is 1164275566 and her current mailing address is 10200 Grand Central Ave Ste 220, Owings Mills, Maryland. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1164275566.
Provider's Profile
| Full Name | Kali Renee Rutherford |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 1405 S Sizer Ave Ste A, Jefferson Cty, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1164275566
- Provider Enumeration Date: 04/08/2024
- Last Update Date: 06/05/2026
Medical Identifiers
Medical identifiers for Kali Renee Rutherford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164275566 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | 5906 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kali Renee Rutherford is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kali Renee Rutherford, PA
10200 Grand Central Ave Ste 220,
Owings Mills, MD 21117-4366
Ph: (865) 690-3811 | Kali Renee Rutherford, PA
1405 S Sizer Ave Ste A,
Jefferson Cty, TN 37760-2421
Ph: (865) 690-3811 |
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