Theodore Eugene Kalutz, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

8535 Issued in SC

Practice address

1346 Haile Street
Camden, SC 29020

Phone

(803) 432-1931

Fax

(803) 432-1176

NPI assigned

Feb 9, 2006

Last updated

Jan 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Associates PA

  • Pediatrics Physician
  • Camden, SC
  • NPI 1730121179
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1558334672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1346 HAILE STREET",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "29020",
            "telephone_number": "803-432-1931",
            "fax_number": "803-432-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 HAILE STREET",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "29020",
            "telephone_number": "803-432-1931",
            "fax_number": "803-432-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALUTZ",
        "first_name": "THEODORE",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "8535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085357",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas N Joseph, MD
• Janice Smith Joyner
• JP Smith Builders, LLC
• Guy Beyer Kahler, M.D.
• Kairos Clinical Services LLC
• Whitney R Keen
• Susan Jane Kelly-Lowery
• Amanda Kendall, MCD,CCC-SLP
• Kershaw Anesthesia, LLC
• Kershaw Cnty Psych LLC

• Pediatrics Physician in Camden, SC
• Providers in Camden, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; 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.