Individual provider Active NPI

Justin Tyler Kutz, PTA

  • Physical Therapy Assistant
  • Denver, CO
National Provider Identifier
1013272384
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
12813 Issued in CO
Practice address
4380 S Monaco St
Unit 5044
Denver, CO 80237-3490
Phone
(970) 580-3373
NPI assigned
Jul 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 12813 CO Primary
Physical Therapy Assistant 225200000X 14-02337 KS

Addresses

Primary practice location

4380 S Monaco St
Unit 5044
Denver, CO 80237-3490

Mailing address

4380 S Monaco St
Unit 5044
Denver, CO 80237-3490
Phone (970) 580-3373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12813COMDPhysical Therapist
14-02337KSMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1013272384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 S MONACO ST",
            "address_2": "UNIT 5044",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373490",
            "telephone_number": "970-580-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 S MONACO ST",
            "address_2": "UNIT 5044",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373490",
            "telephone_number": "970-580-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTZ",
        "first_name": "JUSTIN",
        "middle_name": "TYLER",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "12813",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "14-02337",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.