Active NPI
Melissa Hutchison
- Physical Therapist
- Vandalia, IL
National Provider Identifier
1033314604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 825 New York Dr
Vandalia, IL 62471-1044 - Phone
- (618) 283-5545
- Fax
- (618) 283-2951
- NPI assigned
- Jun 15, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | IL | Primary |
Addresses
Primary practice location
825 New York Dr
Vandalia, IL 62471-1044
Mailing address
611 Bow Dr
Vandalia, IL 62471-1403
Phone (618) 283-1232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 376012895001 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070004046 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033314604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 BOW DR",
"city": "VANDALIA",
"state": "IL",
"postal_code": "624711403",
"telephone_number": "618-283-1232",
"fax_number": "618-283-4933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 NEW YORK DR",
"city": "VANDALIA",
"state": "IL",
"postal_code": "624711044",
"telephone_number": "618-283-5545",
"fax_number": "618-283-2951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTCHISON",
"first_name": "MELISSA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "376012895001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vandalia, IL
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.