NPIMap

Individual provider Active NPI

Jennifer E Lutz, MPT

  • Physical Therapist
  • Mount Orab, OH
National Provider Identifier
1073580155
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT08968 Issued in OH
Practice address
108 Glover Dr
Mount Orab, OH 45154-8390
Phone
(937) 444-2933
Fax
(937) 444-2924
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT08968 OH Primary

Addresses

Primary practice location

108 Glover Dr
Mount Orab, OH 45154-8390

Mailing address

108 Glover Dr.
Mt. Orab, OH 45154
Phone (937) 444-2933

Other identifiers 2

IdentifierTypeStateIssuer
000000561960OtherANTHEM
2699512MedicaidOH

Other names 1

  • Ms. Jennifer L Lutz Former name

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

State licenses

LicenseStateTypeSpecialty
PT08968OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Consultants of Cincinnati, Inc. Past Accepting new patients
Eastgate Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients
Eastgate Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1073580155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 GLOVER DR.",
            "city": "MT. ORAB",
            "state": "OH",
            "postal_code": "45154",
            "telephone_number": "937-444-2933",
            "fax_number": "937-444-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 GLOVER DR",
            "city": "MOUNT ORAB",
            "state": "OH",
            "postal_code": "451548390",
            "telephone_number": "937-444-2933",
            "fax_number": "937-444-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT08968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000561960",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2699512",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LUTZ",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Orab, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.