Individual provider Active NPI

John Dylan Kohutka, DPT

  • Physical Therapist
  • Blue Bell, PA
National Provider Identifier
1326515958
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT029093 Issued in PA
Practice address
1524 Dekalb Pike
Blue Bell, PA 19422-3368
Phone
(610) 275-0330
NPI assigned
Nov 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT6573 MS
Physical Therapist 225100000X PT029093 PA Primary

Addresses

Primary practice location

1524 Dekalb Pike
Blue Bell, PA 19422-3368

Mailing address

1524 Dekalb Pike
Blue Bell, PA 19422-3368
Phone (610) 275-0330

Other practice location 1

1220 N Shore Pkwy Ste B
Brandon, MS 39047-6383
Phone (601) 829-0505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210225000118 PA Practitioner - Physical Therapist in Private Practice 7719231075 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6573MSMDPhysical Therapist
PT029093PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics SPT, Inc. CurrentSince Nov 13, 2023 Accepting new patients
Rehabclinics SPT, Inc. CurrentSince Nov 13, 2023 Accepting new patients
Orthopedic and Sports Physical Therapy Services, Inc. Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Rehabclinics (SPT), Inc. Physical Therapist Current Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients

Locations

1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

4275 County Line Rd
Ste 26
Chalfont, PA 18914
Phone (267) 952-8120

604 Commons Dr
Ste D3
Oxford, PA 19363
Phone (610) 932-3619

528 Kimberton Rd
Phoenixville, PA 19460
Phone (610) 933-6232

Organizations & group practices 5

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": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1326515958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 DEKALB PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194223368",
            "telephone_number": "610-275-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 DEKALB PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194223368",
            "telephone_number": "610-275-0330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 N Shore Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "MS",
            "postal_code": "390476383",
            "country_code": "US",
            "telephone_number": "601-829-0505",
            "fax_number": "601-829-0506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHUTKA",
        "first_name": "JOHN",
        "middle_name": "DYLAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-01",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6573",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Bell, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.