Individual provider Active NPI

Adam Hutchison, PT, DPT

  • Physical Therapist
  • Crown Point, IN
National Provider Identifier
1285125013
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05014859A Issued in IN
Practice address
11275 Delaware Pkwy Ste B
Crown Point, IN 46307-7812
Phone
(219) 663-8766
Fax
(219) 663-8769
NPI assigned
May 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 017465 OH
Physical Therapist 225100000X 05014859A IN Primary
Physical Therapist 225100000X PT017465 FL

Addresses

Primary practice location

11275 Delaware Pkwy Ste B
Crown Point, IN 46307-7812

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Other practice location 1

1348 S 18th St Ste 320A
Fernandina Beach, FL 32034-4785
Phone (904) 557-9021

Other practice location 2

1325 San Marco Blvd Ste 102
Jacksonville, FL 32207-8549
Phone (904) 858-7045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221109000229 IN Practitioner - Physical Therapist in Private Practice 9931456332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11275 Delaware Pkwy
Suite B
Crown Point, IN 46307-7812
Phone (219) 663-8766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017465FLMDPhysical Therapist
05014859AINMDPhysical Therapist
017465OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Nov 28, 2022 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Nov 28, 2022 Accepting new patients
Jacksonville Orthopaedic Institute Inc Physical Therapist PastSince Jun 14, 2018 Accepting new patients

Locations

11275 Delaware Pkwy
#B
Crown Point, IN 46307
Phone (219) 304-6074

1805 E Hoffer St
Kokomo, IN 46902
Phone (765) 450-7261

5 Broadway Plz
Peru, IN 46970
Phone (765) 327-2111

3319 Willowcreek Rd
Portage, IN 46368
Phone (574) 544-5434

2502 Calumet Ave
Valparaiso, IN 46383
Phone (219) 280-2034

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1285125013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11275 DELAWARE PKWY STE B",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077812",
            "telephone_number": "219-663-8766",
            "fax_number": "219-663-8769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1348 S 18th St Ste 320A",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320344785",
            "country_code": "US",
            "telephone_number": "904-557-9021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1325 San Marco Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078549",
            "country_code": "US",
            "telephone_number": "904-858-7045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTCHISON",
        "first_name": "ADAM",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "017465",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05014859A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT017465",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.