Individual provider Active NPI

Carol Countryman Kutteh, MD

  • Obstetrics & Gynecology Physician
  • Germantown, TN
National Provider Identifier
1720544398
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
27764 Issued in TN
Practice address
9250 Glenda Rd
Germantown, TN 38139-6702
Phone
(901) 752-5524
Fax
(901) 747-4446
NPI assigned
Feb 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 14353 AL
Obstetrics & Gynecology Physician 207V00000X J0982 TX
Obstetrics & Gynecology Physician 207V00000X 27764 TN Primary

Addresses

Primary practice location

9250 Glenda Rd
Germantown, TN 38139-6702

Mailing address

9250 Glenda Rd
Germantown, TN 38139-6702
Phone (901) 752-5524

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14353ALMDObstetrics & Gynecology Physician
27764TNMDObstetrics & Gynecology Physician
J0982TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reproductive Laboratory Inc Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1720544398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 GLENDA RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381396702",
            "telephone_number": "901-752-5524",
            "fax_number": "901-747-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 GLENDA RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381396702",
            "telephone_number": "901-752-5524",
            "fax_number": "901-747-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTTEH",
        "first_name": "CAROL",
        "middle_name": "COUNTRYMAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "14353",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J0982",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "27764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.