Individual provider Active NPI

Richard R Tutt, M.D.

  • Obstetrics & Gynecology Physician
  • Tyler, TX
National Provider Identifier
1417049529
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
F4620 Issued in TX
Practice address
700 Olympic Plaza Cir
Suite #504
Tyler, TX 75701-1951
Phone
(903) 593-6155
Fax
(903) 593-9446
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X F4620 TX Primary

Addresses

Primary practice location

700 Olympic Plaza Cir
Suite #504
Tyler, TX 75701-1951

Mailing address

700 Olympic Plaza Cir
Suite #504
Tyler, TX 75701-1951
Phone (903) 593-6155

Other identifiers 1

IdentifierTypeStateIssuer
132090501MedicaidTX

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1417049529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR",
            "address_2": "SUITE #504",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011951",
            "telephone_number": "903-593-6155",
            "fax_number": "903-593-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR",
            "address_2": "SUITE #504",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011951",
            "telephone_number": "903-593-6155",
            "fax_number": "903-593-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTT",
        "first_name": "RICHARD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "F4620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132090501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.