Active NPI
Charles Herman Kuttner, M.D.
- Psychiatry Physician
- Portland, OR
National Provider Identifier
1417954512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 9934
- Practice address
- 2400 SW Vermont St
Portland, OR 97219-1940 - Phone
- (503) 452-0915
- Fax
- (503) 768-9232
- NPI assigned
- Jul 5, 2005
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 9934 | OR | Primary |
Addresses
Primary practice location
2400 SW Vermont St
Portland, OR 97219-1940
Mailing address
2400 SW Vermont St
Portland, OR 97219-1940
Phone (503) 452-0915
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9934 | OR | MD | Physical Therapy Assistant |
Interoperability endpoints
- ckuttner@direct.fannocreek.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219708800000",
"number": "1417954512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 SW VERMONT ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972191940",
"telephone_number": "503-452-0915",
"fax_number": "503-768-9232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 SW VERMONT ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972191940",
"telephone_number": "503-452-0915",
"fax_number": "503-768-9232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUTTNER",
"first_name": "CHARLES",
"middle_name": "HERMAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2008-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "9934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.