Individual provider Active NPI

Richard B Lutton, M.D.

  • Family Medicine Physician
  • Bandera, TX
National Provider Identifier
1114921152
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G6787 Issued in TX
Practice address
1050 Hwy 16 S
Bandera, TX 78003
Phone
(830) 796-7713
Fax
(830) 796-7744
NPI assigned
Jun 8, 2005
Last updated
Jun 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G6787 TX Primary

Addresses

Primary practice location

1050 Hwy 16 S
Bandera, TX 78003

Mailing address

1051 US Highway 90 E
Castroville, TX 78009-5210
Phone (830) 931-3336

Other identifiers 1

IdentifierTypeStateIssuer
126866608MedicaidTX

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 Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Emergency Associates LLC Past Accepting new patients
South Texas Hospitalist Associates LLC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1114921152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 US HIGHWAY 90 E",
            "city": "CASTROVILLE",
            "state": "TX",
            "postal_code": "780095210",
            "telephone_number": "830-931-3336",
            "fax_number": "830-931-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 HWY 16 S",
            "city": "BANDERA",
            "state": "TX",
            "postal_code": "78003",
            "telephone_number": "830-796-7713",
            "fax_number": "830-796-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTTON",
        "first_name": "RICHARD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G6787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126866608",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bandera, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.