Active NPI
Mary D Hutton, L.M.T., N.C.T.M.
- Specialist
- Kennesaw, GA
National Provider Identifier
1114207164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MT001419
- Practice address
- 825 Registry Ter NW
Kennesaw, GA 30152-2855 - Phone
- (770) 429-0208
- Fax
- (404) 745-0707
- NPI assigned
- Aug 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | MT001419 | GA | Primary |
Addresses
Primary practice location
825 Registry Ter NW
Kennesaw, GA 30152-2855
Mailing address
825 Registry Ter NW
Kennesaw, GA 30152-2855
Phone (770) 429-0208
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 |
|---|---|---|---|
| MT001419 | GA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314057600000",
"number": "1114207164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 REGISTRY TER NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301522855",
"telephone_number": "770-429-0208",
"fax_number": "404-745-0707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 REGISTRY TER NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301522855",
"telephone_number": "770-429-0208",
"fax_number": "404-745-0707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTTON",
"first_name": "MARY",
"middle_name": "D",
"name_prefix": "Ms.",
"credential": "L.M.T., N.C.T.M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-23",
"last_updated": "2011-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "MT001419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.