Active NPI
Kenneth William Cutler, M.D.
- Pediatrics Physician
- Grass Valley, CA
National Provider Identifier
1285786889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G 70200
- Practice address
- 500 Crown Point Cir
Grass Valley, CA 95945-9561 - Phone
- (530) 265-7154
- NPI assigned
- Jan 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G 70200 | CA | Primary |
Addresses
Primary practice location
500 Crown Point Cir
Grass Valley, CA 95945-9561
Mailing address
PO Box 10047
Truckee, CA 96162-0047
Phone (530) 448-1798
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G070200 | Other | CA | STATE LICENSE NUMBER |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G 70200 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438214400000",
"number": "1285786889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10047",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961620047",
"telephone_number": "530-448-1798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 CROWN POINT CIR",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959459561",
"telephone_number": "530-265-7154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUTLER",
"first_name": "KENNETH",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-17",
"last_updated": "2015-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G 70200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "G070200",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.