Individual provider Active NPI

Kimberly Kay Hutton, MD

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1609828680
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21187 Issued in OK
Practice address
4500 S 129TH East Ave
Suite 191
Tulsa, OK 74134-5801
Phone
(918) 392-4544
Fax
(918) 779-7425
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21187 OK Primary

Addresses

Primary practice location

4500 S 129TH East Ave
Suite 191
Tulsa, OK 74134-5801

Mailing address

4500 S 129TH E Ave,
Suite 191
Tulsa, OK 74134-5891
Phone (918) 392-4544

Other identifiers 1

IdentifierTypeStateIssuer
100230690AMedicaidOK

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mayes County Hma, LLC Past Accepting new patients
Ahs Oklahoma Physician Group LLC Family Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1609828680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S 129TH E AVE,",
            "address_2": "SUITE 191",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741345891",
            "telephone_number": "918-392-4544",
            "fax_number": "918-779-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S 129TH EAST AVE",
            "address_2": "SUITE 191",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741345801",
            "telephone_number": "918-392-4544",
            "fax_number": "918-779-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTON",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "21187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100230690A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.