Katelyn McCormick Hutchison, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2011020346 Issued in MO

Practice address

375TH Medical Group
310 West Losey Street
Scott AFB, IL 62225

Phone

(616) 256-6280

NPI assigned

Jul 13, 2011

Last updated

Aug 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Katelyn Hill McCormick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Babar Enterprises LLC

  dba Excel Sports & Physical Therapy

  • Physical Therapist
  • Creve Coeur, MO
  • NPI 1033178827
  NPD (past)
• Babar Enterprises LLC

  dba Excel Sports and Physical Therapy

  • Physical Therapist
  • Warrenton, MO
  • NPI 1548425002
  NPD (past)

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1356639231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375TH MEDICAL GROUP",
            "address_2": "310 WEST LOSEY STREET",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "62225",
            "telephone_number": "616-256-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375TH MEDICAL GROUP",
            "address_2": "310 WEST LOSEY STREET",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "62225",
            "telephone_number": "616-256-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHISON",
        "first_name": "KATELYN",
        "middle_name": "MCCORMICK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2011020346",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13806876",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "MCCORMICK",
            "middle_name": "HILL",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Relinda Denise Hayes, LCSW
• Deborah Leigh Henry, PA-C
• Seth Heying
• Helen M Horn, WHNP
• Justin C Huang, MD
• Youseline Jean-Louis, NP
• Jill Kinsella DMD LLC
• Loren Mark Johnson, M.D.
• Mark D. Johnson, OD
• Cheryl D Jones, RN

• Physical Therapist in Scott AFB, IL
• Providers in Scott AFB, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.