Active NPI
Mae Kristine Luengo Barut
- Physical Therapist
- Indianapolis, IN
National Provider Identifier
1467967273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10290
- Practice address
- 7345 Woodland Dr Ste C
Indianapolis, IN 46278-1737 - Phone
- (317) 286-2885
- Fax
- (317) 536-3097
- NPI assigned
- Dec 4, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 10290 | Primary |
Addresses
Primary practice location
7345 Woodland Dr Ste C
Indianapolis, IN 46278-1737
Mailing address
7345 Woodland Dr Ste C
Indianapolis, IN 46278-1737
Phone (317) 286-2885
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512345600000",
"number": "1467967273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7345 WOODLAND DR STE C",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462781737",
"telephone_number": "317-286-2885",
"fax_number": "317-536-3097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7345 WOODLAND DR STE C",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462781737",
"telephone_number": "317-286-2885",
"fax_number": "317-536-3097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARUT",
"first_name": "MAE KRISTINE",
"middle_name": "LUENGO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-04",
"last_updated": "2017-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": "10290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.