Charles Randall Hutton, D.D.S.
Individual provider Active NPI General Practice Dentistry · Winamac, IN
NPI 1265545461 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1265545461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12007612A (IN)
- Practice address
- 201 E Adams St
Winamac, IN 46996-1567 - Phone
- (574) 946-6747
- Fax
- (574) 946-4323
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Owned or controlled facilities with NPI records 14
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
All facility ownership & control disclosures 14
| Facility | Type | Role | Since |
|---|---|---|---|
| Pulaski Memorial Hospital |
Hospital | Corporate Director (14.29%) | Aug 27, 2002 |
| Pulaski Memorial Hospital |
Hospital | Corporate Director (14.29%) | Aug 27, 2014 |
| Pulaski Health Care Center |
Skilled nursing facility | Corporate Director (14.29%) | Aug 27, 2014 |
| Parkview Haven |
Skilled nursing facility | Corporate Director (14.29%) | Aug 27, 2002 |
| Kingston Health Center of Fort Wayne |
Skilled nursing facility | Trustee of the SNF | Dec 16, 2025 |
| Briarcliff Health & Rehabilitation Center |
Skilled nursing facility | Corporate Director (100%) | Jan 1, 2024 |
| South Shore Health & Rehabilitation Center |
Skilled nursing facility | Corporate Director (100%) | Jan 1, 2024 |
| Asbury Towers Health Care Center |
Skilled nursing facility | Managing Control - Governing Body | Jul 1, 2024 |
| Healthwin Health & Rehabilitation |
Skilled nursing facility | Trustee of the SNF | Jan 8, 2025 |
| Pulaski Memorial Hospital |
Rural health clinic | Corporate Director | Aug 27, 2002 |
| Pulaski Memorial Hospital Francesville Family Medicine |
Rural health clinic | Corporate Director | Aug 27, 2002 |
| Pulaski Memorial Hospital North Judson Family Medicine |
Rural health clinic | Corporate Director | Aug 27, 2002 |
| Pulaski Memorial Hospital Knox Medical Center |
Rural health clinic | Corporate Director | Aug 27, 2002 |
| Pulaski Memorial Hospital Culver Medical Center |
Rural health clinic | Corporate Director | Aug 27, 2002 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150423001308 | IN | Order and Referring Only - Oral Surgery |
8527287333 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12007612A | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles R. Hutton D.D.S.,PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12007612A | IN | Yes |
Addresses
Primary practice location
201 E Adams St
Winamac, IN 46996-1567
Mailing address
201 E Adams St
Winamac, IN 46996-1567
Phone (574) 946-6747
Other providers in Winamac, IN
- Bruce D Hermann
- Teresa L Hiatt
- Ruth A Hood
- Hook-Superx LLC
- Hannah Howell
- Jennifer M Gudas OD, PC
- Brian Alan Johnson
- David P Johnson
- Clinton L. Kauffman
- Michael Ryan Keller
All providers in Winamac, IN · General Practice Dentistry in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.