Mark R Kutyla DPM PA

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

516 Issued in SC

Legal business name

MARK R KUTYLA DPM PA

Practice address

121 Park Place CT
Lexington, SC 29072-6690

Phone

(803) 356-4712

Fax

(803) 356-0832

NPI assigned

May 22, 2006

Organization subpart

Yes

Parent organization

MARK R KUTYLA DPM PAAs reported in NPPES

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

Authorized official

Name

Dr. Mark R Kutyla, D.P.M.

Title

President

Phone

(803) 356-4712

Specialties & licenses 8

Addresses

Other identifiers 3

Other names 1

• MIDLANDS FOOT CLINIC Doing business as

Part of

Mark R Kutyla DPM PA

Locations

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320537600000",
    "number": "1720032816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PARK PLACE CT",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290726690",
            "telephone_number": "803-356-4712",
            "fax_number": "803-356-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PARK PLACE CT",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290726690",
            "telephone_number": "803-356-4712",
            "fax_number": "803-356-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R KUTYLA DPM PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARK R KUTYLA DPM PA",
        "enumeration_date": "2006-05-22",
        "last_updated": "2011-11-06",
        "status": "A",
        "authorized_official_last_name": "KUTYLA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-356-4712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "SC",
            "license": "516",
            "primary": true
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Radiology",
            "state": "SC",
            "license": "516",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": "SC",
            "license": "516",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "SC",
            "license": "516",
            "primary": false
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "SC",
            "license": "516",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "516",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "SC",
            "license": "516",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "SC",
            "license": "516",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NO.",
            "identifier": "7238051",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACM # MIDLANDS FOOT CL.",
            "identifier": "1020003",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATE OF WAIVER",
            "identifier": "42D2021725",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIDLANDS FOOT CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary K Mangione, FNP-C
• Stacy Manley
• John Bennett Manna, NP-C
• Christine Shauvon Manning
• June K Maranville, MSP, CCC-SLP
• Heather Marlowe, RN
• Tammy Joan Marsh, ATC
• Jeremy Marshall
• Beverly A Martin-Davis, RN
• Dina Marie Martin, RN, AGNP

• Primary Podiatric Medicine Podiatrist in Lexington, SC
• Providers in Lexington, SC by specialty
• Primary Podiatric Medicine Podiatrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2011; 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.