Mark R Dutton, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

00007051 Issued in WA

Practice address

21 NE Romance Hill Rd Ste 101
Belfair, WA 98528-0457

Phone

(360) 275-6612

Fax

(360) 275-6658

NPI assigned

Aug 9, 2005

Last updated

Mar 3, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Physical Therapy PCGroup PAC ID 5193612273, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Independent Physical Therapy, PC

  dba Peninsula Physical Therapy

  • Physical Therapist
  • Belfair, WA
  • NPI 1982721874
  Medicare reassignment Care Compare group
• Independent Physical Therapy, Inc

  dba Kitsap Physical Therapy

  • Physical Therapist
  • Belfair, WA
  • NPI 1063527497
  NPD (past) Authorized official

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1265433601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "address_2": "21 NE ROMANCE HILL RD STE 101",
            "city": "BELFAIR",
            "state": "WA",
            "postal_code": "985289626",
            "telephone_number": "360-275-6612",
            "fax_number": "360-275-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 NE ROMANCE HILL RD STE 101",
            "city": "BELFAIR",
            "state": "WA",
            "postal_code": "985280457",
            "telephone_number": "360-275-6612",
            "fax_number": "360-275-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "00007051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8336422",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "146767",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "193242800",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annelies De Wolf, DPT, MPH
• Thomas J Degan, MD
• Amanda Kay Donahue, MS, RD, CD
• Donald R Lepere DDS PS
• Elizabeth Grace Donals
• Ehresman Family Chiropractic
• Carl Edward Ehresman II, D.C.
• Jorrell-Mark Taladiar Elbo, L.M.P.
• Jody Ellis, E.A.M.P, LAC., MSA
• Hannah Elizabeth Booth Erickson, PA-C

• Physical Therapist in Belfair, WA
• Providers in Belfair, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.