Active NPI
Debra Sue Kutz, PT
- Physical Therapist
- Stillwater, MN
National Provider Identifier
1487967998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2254
- Practice address
- 1119 Owens St N
Stillwater, MN 55082-4316 - Phone
- (651) 439-7180
- NPI assigned
- Jul 26, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2254 | MN | Primary |
| Physical Therapist | 225100000X | 1627-24 | WI |
Addresses
Primary practice location
1119 Owens St N
Stillwater, MN 55082-4316
Mailing address
2323 Donegal Way
Hudson, WI 54016-9121
Phone (715) 386-7760
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 |
|---|---|---|---|
| 2254 | MN | MD | Professional Counselor |
| 1627-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280102400000",
"number": "1487967998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2323 DONEGAL WAY",
"city": "HUDSON",
"state": "WI",
"postal_code": "540169121",
"telephone_number": "715-386-7760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1119 OWENS ST N",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550824316",
"telephone_number": "651-439-7180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUTZ",
"first_name": "DEBRA",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-26",
"last_updated": "2010-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "2254",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "1627-24",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.