Individual provider Active NPI

George Christopher Kutteruf, MD

  • Gastroenterology Physician
  • Coeur d'Alene, ID
National Provider Identifier
1235211582
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
M3978 Issued in ID
Practice address
1607 Lincoln Way
Suite 200
Coeur D Alene, ID 83814-2476
Phone
(208) 667-5483
Fax
(208) 667-5483
NPI assigned
Oct 19, 2006
Last updated
Dec 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X M3978 ID Primary

Addresses

Primary practice location

1607 Lincoln Way
Suite 200
Coeur D Alene, ID 83814-2476

Mailing address

1607 Lincoln Way
Suite 200
Coeur D Alene, ID 83814-2476
Phone (208) 667-5483

Other identifiers 1

IdentifierTypeStateIssuer
002499400MedicaidID

Other names 1

  • G C Kutteruf Professional 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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M3978IDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kutteruf and Robinson MD PA Gastroenterology Current Accepting new patients
R. Randy Hopkins M.D. P.a Gastroenterology Current Accepting new patients

Locations

1607 Lincoln Way
Ste 200
Coeur D Alene, ID 83814
Phone (208) 667-5483

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229299200000",
    "number": "1235211582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 LINCOLN WAY",
            "address_2": "SUITE 200",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142476",
            "telephone_number": "208-667-5483",
            "fax_number": "208-667-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 LINCOLN WAY",
            "address_2": "SUITE 200",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142476",
            "telephone_number": "208-667-5483",
            "fax_number": "208-667-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTTERUF",
        "first_name": "GEORGE",
        "middle_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ID",
            "license": "M3978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002499400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "G",
            "last_name": "KUTTERUF",
            "middle_name": "C",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.