Active NPI
Makenzie Elaine Utterback, PA-C
- Medical Physician Assistant
- Terre Haute, IN
National Provider Identifier
1649888744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 10003042A
- Practice address
- 2723 S 7TH St Ste a
Terre Haute, IN 47802-3558 - Phone
- (812) 232-8164
- Fax
- (812) 234-6391
- NPI assigned
- Jul 15, 2020
- Last updated
- Sep 6, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 10003042A | IN | Primary |
Addresses
Primary practice location
2723 S 7TH St Ste a
Terre Haute, IN 47802-3558
Mailing address
2723 S 7TH St Ste a
Terre Haute, IN 47802-3558
Phone (812) 232-8164
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1606 N 7TH St
Providence Medical Group
Terre Haute, IN 47804-2706
Phone (812) 232-8164
2723 S 7TH St
Terre Haute, IN 47802-3558
2723 S 7TH St a
Terre Haute, IN 47802-3558
2723 S 7TH St C
Terre Haute, IN 47802-3558
Phone (812) 232-5936
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Union Hospital Inc. | Current | Accepting new patients |
Interoperability endpoints
- mutterback@unionhealth.cernerdirect.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Terre Haute, IN
- NPI 1891729141
-
- General Acute Care Hospital
- Terre Haute, IN
- NPI 1619975331
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Linton, IN
- NPI 1184695389
-
- Critical Access Hospital Clinic/Center
- Sullivan, IN
- NPI 1487450698
-
- Critical Access Hospital
- Sullivan, IN
- NPI 1497759260
-
- General Acute Care Hospital
- Terre Haute, IN
- NPI 1619975331
-
- General Acute Care Hospital
- Terre Haute, IN
- NPI 1821859752
-
- General Acute Care Hospital
- Clinton, IN
- NPI 1093713802
-
dba CMH Specialty Clinic-Newton
- Urology Physician
- Newton, IL
- NPI 1265309405
Hospital
-
dba Crawford Memorial Hospital and Health Services
- Critical Access Hospital
- Robinson, IL
- NPI 1265493720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1649888744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2723 S 7TH ST STE A",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478023558",
"telephone_number": "812-232-8164",
"fax_number": "812-234-6391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2723 S 7TH ST STE A",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478023558",
"telephone_number": "812-232-8164",
"fax_number": "812-234-6391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTTERBACK",
"first_name": "MAKENZIE",
"middle_name": "ELAINE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-15",
"last_updated": "2023-09-06",
"certification_date": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IN",
"license": "10003042A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terre Haute, IN
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- Melih Ustaoglu, MD
- Usv Optical Inc.
- Francis Joseph Patri Estepa Uypuanco, RPT
- Nkiru Uzowulu
- Rohit Vadlamani, MSOB, DMD
- Valley Professionals Community Health Center Inc (VPCHC - Springhill)
- Valley Professionals Community Health Center Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.