Individual provider Active NPI

Philip K Mutter, DPT

  • Physical Therapist
  • Evansville, IN
National Provider Identifier
1689009805
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05012073A Issued in IN
Practice address
3519 N Green River Rd
Evansville, IN 47715-1347
Phone
(812) 473-7253
Fax
(812) 473-7264
NPI assigned
Sep 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 006712 KY
Physical Therapist 225100000X 05012073A IN Primary

Addresses

Primary practice location

3519 N Green River Rd
Evansville, IN 47715-1347

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160317002252 KY Practitioner - Physical Therapist in Private Practice 3870815533 Reassigns benefits to 1 organization
I20160720000650 IN Practitioner - Physical Therapist in Private Practice 3870815533 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Physical Therapy of Ky LLCGroup PAC ID 0042577579, 55 clinicians
Benchmark Physical Therapy Indiana LLCGroup PAC ID 2264846369, 14 clinicians

Practice addresses (Care Compare)

1588 Leestown Rd
Suite 120
Lexington, KY 40511-2365
Phone (859) 317-8086

204 Cross County PLZ
Batesville, IN 47006-8914
Phone (812) 803-2408

3800 Frederica St
Suite 1a
Owensboro, KY 42301-6970
Phone (270) 745-9555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy Indiana LLC Physical Therapist CurrentSince Apr 29, 2022 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Sep 19, 2016 Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. CurrentSince May 24, 2016 Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. Current Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. Physical Therapist CurrentSince May 24, 2016 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Sep 19, 2016 Accepting new patients
Benchmark Physical Therapy of Ky LLC Physical Therapist CurrentSince Oct 4, 2021 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

204 Cross County Plz
Batesville, IN 47006
Phone (812) 803-2408

474 W Plaza Dr
Columbia City, IN 46725
Phone (260) 244-8009

225 Crosslake Dr
Evansville, IN 47715
Phone (812) 471-6677

7300 E Indiana St
Ste 102
Evansville, IN 47715
Phone (812) 759-7451

415 Crosslake Dr
Ste B
Evansville, IN 47715
Phone (812) 476-0764

3519 N Green River Rd
Evansville, IN 47715
Phone (812) 437-1420

6240 E Virginia St
Ste E
Evansville, IN 47715
Phone (812) 909-9171

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

8887 High Pointe Dr
Ste E
Newburgh, IN 47630
Phone (812) 759-7464

2121 Willow St
Vincennes, IN 47591
Phone (812) 882-1141

1588 Leestown Rd
Ste 120
Lexington, KY 40511
Phone (859) 317-8086

3800 Frederica St
Ste 1A
Owensboro, KY 42301
Phone (270) 495-4332

3000 Alvey Park Dr W
Ste C
Owensboro, KY 42303
Phone (270) 240-4694

Organizations & group practices 7

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": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1689009805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 N GREEN RIVER RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477151347",
            "telephone_number": "812-473-7253",
            "fax_number": "812-473-7264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTTER",
        "first_name": "PHILIP",
        "middle_name": "K",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-06",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "006712",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05012073A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.