MEDICARE: RUTHERFORD MENTAL WELLNESS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1124893342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUTHERFORD MENTAL WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	214 CHARLOTTE RD
Second Line	:
City	:	RUTHERFORDTON
State	:	NC
Zip	:	28139-2914
Country	:	US
Telephone Number	:	828-447-2253
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 CHARLOTTE RD
Second Line	:
City	:	RUTHERFORDTON
State	:	NC
Zip	:	28139-2914
Country	:	US
Telephone Number	:	828-447-2253
Fax Number	:	828-372-4642

Authorized Official
Title or Position	:	OWNER/PRACTITIONER
Name	:	SHANNON JONES
Credential	:	PMHNP-BC
Telephone Number	:	828-447-2253

Provider Enumeration Date	:	11/17/2023
Last Update Date	:	05/01/2025

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