Individual provider Active NPI

John R Jutting Jr., MD

  • Family Medicine Physician
  • Fort Defiance, AZ
National Provider Identifier
1265574800
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME105020 Issued in FL
Practice address
Corner of Route N12 and N7
Fort Defiance, AZ 86504
Phone
(928) 729-8000
NPI assigned
Feb 12, 2007
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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 ME105020 FL Primary

Addresses

Primary practice location

Corner of Route N12 and N7
Fort Defiance, AZ 86504

Mailing address

PO Box 649
Fort Defiance, AZ 86504-0649
Phone (928) 729-8000

Other practice location 1

12301 Lake Underhill Rd Ste 215
Orlando, FL 32828-4511
Phone (321) 235-0692

Other identifiers 3

IdentifierTypeStateIssuer
001219300MedicaidFL
1265574800OtherFLTRICARE
145QQOtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, LA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090824000631 FL Practitioner - Family Practice 5092869131 Reassigns benefits to 3 organizations
I20250703000664 TX Practitioner - Family PracticePractitioner - Preventive Medicine 5092869131 Reassigns benefits to 1 organization
I20251125002206 LA Practitioner - Emergency Medicine 5092869131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Carroll Health Systems, LLCGroup PAC ID 5294627774, shared by 8 NPIs, 21 clinicians

Practice addresses (Care Compare)

706 Ross St
Oak Grove, LA 71263-9798
Phone (318) 428-3237

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carespot of Orlando Hsi Urgent Care LLC Family Medicine CurrentSince Aug 14, 2020 Accepting new patients
West Carroll Health Systems LLC CurrentSince Oct 26, 2025 Accepting new patients
Ormond Medical Arts Family Practice LLC Family Medicine CurrentSince Sep 15, 2020 Accepting new patients
West Carroll Health Systems LLC CurrentSince Oct 27, 2025 Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Jun 23, 2025 Accepting new patients
Shands/Solantic Joint Venture, LLC CurrentSince Aug 14, 2020 Accepting new patients
Radiology Associates a Professional Corporation Past Accepting new patients
Emergency Medicine Professionals PA Past Accepting new patients
Bay View Urgent Care LLC Family Medicine PastSince Apr 1, 2010 Accepting new patients

Locations

3840 State Road 436
Ste 1
Apopka, FL 32703
Phone (407) 478-3202

3581 SW Archer Rd
Ste 40
Gainesville, FL 32608
Phone (352) 888-4449

720 SW 2nd Ave
Ste 160A
Gainesville, FL 32601
Phone (352) 240-8000

2555 S Kirkman Rd
Orlando, FL 32811
Phone (407) 362-2030

77 W Granada Blvd
Ormond Beach, FL 32174
Phone (386) 677-0453

706 Ross St
Oak Grove, LA 71263
Phone (318) 428-3237

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1579/brand/8/csg/141/fhir/r4
  • Direct secure messaging: johnrjutting@fhcpfl.allscriptsdirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1265574800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12301 Lake Underhill Rd Ste 215",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328284511",
            "country_code": "US",
            "telephone_number": "321-235-0692",
            "fax_number": "321-235-0694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUTTING",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2025-07-03",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME105020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001219300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1265574800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "145QQ",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

Verify at the official NPI Registry.