Kelli Renee Luttrell, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

H0068495 Issued in MD

Practice address

1647 Woodbrooke Dr
Salisbury, MD 21804-8502

Phone

(410) 546-2424

Fax

(410) 742-6633

NPI assigned

Aug 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

OB Hospitalist Services Delaware PAGroup PAC ID 4880813385, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayhealth Hospital, Sussex Campus Hospital, Milford, DE, CCN 080009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• OB Hospitalist Services Delaware PA

  • Obstetrics & Gynecology Physician
  • Dover, DE
  • NPI 1619304300
  Medicare reassignment Care Compare group NPD
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  NPD (past)
• Bayhealth Medical Center, Inc.

  • General Acute Care Hospital
  • Milford, DE
  • NPI 1023006434
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bayhealth Medical Center, Inc.

  • General Acute Care Hospital
  • Milford, DE
  • NPI 1023006434
  Care Compare affiliation

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

{
    "created_epoch": "1218326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1104072123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1647 WOODBROOKE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218048502",
            "telephone_number": "410-546-2424",
            "fax_number": "410-742-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTTRELL",
        "first_name": "KELLI",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-10",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "H0068495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Irene Ludwig, NURSING ASSISTANT
• Alexandra Wyatt Lujan Naissant, MD
• Katie Lynne Lukehart, LCPC
• David Luppens, D.D.S
• Gary P Luppens, M.D.
• Luxottica of America Inc.
• Luxottica Retail North America Inc
• Lynn F Ascher P a
• Lynn'S Compassion to Care, LLC
• Mac Incorporated

• Obstetrics & Gynecology Physician in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Obstetrics & Gynecology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.