Individual provider Active NPI

George Michael Hutson, PAC

  • Physician Assistant
  • Chandler, AZ
National Provider Identifier
1558456756
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1956 Issued in AZ
Practice address
2905 W Warner Rd
#12
Chandler, AZ 85224-1674
Phone
(480) 831-8457
Fax
(480) 491-3112
NPI assigned
Oct 4, 2006
Last updated
Jun 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1956 AZ Primary

Addresses

Primary practice location

2905 W Warner Rd
#12
Chandler, AZ 85224-1674

Mailing address

2905 W Warner Rd
#12
Chandler, AZ 85224-1674
Phone (480) 831-8457

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lofgreen Family Medicine, PLLC PastSince Dec 10, 2004 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1558456756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 W WARNER RD",
            "address_2": "#12",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241674",
            "telephone_number": "480-831-8457",
            "fax_number": "480-491-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 W WARNER RD",
            "address_2": "#12",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241674",
            "telephone_number": "480-831-8457",
            "fax_number": "480-491-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTSON",
        "first_name": "GEORGE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.