Active NPI
Walter Luttrell
- Physical Therapist
- Versailles, KY
National Provider Identifier
1316397391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 006848
- Practice address
- 374 Kroger Way
Versailles, KY 40383-1915 - Phone
- (859) 286-6848
- NPI assigned
- Jun 21, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 006848 | KY | Primary |
Addresses
Primary practice location
374 Kroger Way
Versailles, KY 40383-1915
Mailing address
374 Kroger Way
Versailles, KY 40383
Phone (859) 286-6848
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466467200000",
"number": "1316397391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "374 KROGER WAY",
"city": "VERSAILLES",
"state": "KY",
"postal_code": "40383",
"telephone_number": "859-286-6848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "374 KROGER WAY",
"city": "VERSAILLES",
"state": "KY",
"postal_code": "403831915",
"telephone_number": "859-286-6848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTTRELL",
"first_name": "WALTER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-21",
"last_updated": "2016-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "006848",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Versailles, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.