Active NPI
Joshua Kutchma, PT
- Physical Therapist
- Alton, IL
National Provider Identifier
1396517934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.027834
- Practice address
- 228 Alton SQ Ste H1
Alton, IL 62002-5919 - Phone
- (618) 463-5171
- Fax
- (618) 463-5175
- NPI assigned
- Oct 26, 2023
- 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 | 070.027834 | IL | Primary |
Addresses
Primary practice location
228 Alton SQ Ste H1
Alton, IL 62002-5919
Mailing address
228 Alton SQ Ste H1
Alton, IL 62002-5919
Phone (618) 463-5171
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.027834 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698278400000",
"number": "1396517934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 ALTON SQ STE H1",
"city": "ALTON",
"state": "IL",
"postal_code": "620025919",
"telephone_number": "618-463-5171",
"fax_number": "618-463-5175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "228 ALTON SQ STE H1",
"city": "ALTON",
"state": "IL",
"postal_code": "620025919",
"telephone_number": "618-463-5171",
"fax_number": "618-463-5175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUTCHMA",
"first_name": "JOSHUA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-26",
"last_updated": "2023-10-26",
"certification_date": "2023-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.027834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.