Active NPI
Samuel Hutchinson, DO
- Psychiatry Physician
- Mesa, AZ
National Provider Identifier
1033630934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 8008
- Practice address
- 4135 S Power Rd
Mesa, AZ 85212-3624 - Phone
- (480) 397-2830
- NPI assigned
- Jun 29, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 8008 | NE | Primary |
Addresses
Primary practice location
4135 S Power Rd
Mesa, AZ 85212-3624
Mailing address
4135 S Power Rd Ste 103
Mesa, AZ 85212-3625
Phone (480) 397-2830
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8008 | NE | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668729600000",
"number": "1033630934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4135 S POWER RD STE 103",
"city": "MESA",
"state": "AZ",
"postal_code": "852123625",
"telephone_number": "480-397-2830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4135 S POWER RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852123624",
"telephone_number": "480-397-2830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTCHINSON",
"first_name": "SAMUEL",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-29",
"last_updated": "2022-11-18",
"certification_date": "2022-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NE",
"license": "8008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.