Active NPI
Leslie Patrick Lutter
- Home Modifications Contractor
- Bronson, IA
National Provider Identifier
1023215811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- Practice address
- 515 E Front St
Bronson, IA 51007-5025 - Phone
- (712) 389-7682
- Fax
- (712) 276-2100
- NPI assigned
- Jun 27, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
515 E Front St
Bronson, IA 51007-5025
Mailing address
515 E Front St
Bronson, IA 51007-5025
Phone (712) 389-7682
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.
{
"created_epoch": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023215811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 E FRONT ST",
"city": "BRONSON",
"state": "IA",
"postal_code": "510075025",
"telephone_number": "712-389-7682",
"fax_number": "712-276-2100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 E FRONT ST",
"city": "BRONSON",
"state": "IA",
"postal_code": "510075025",
"telephone_number": "712-389-7682",
"fax_number": "712-276-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTTER",
"first_name": "LESLIE",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronson, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.