Individual provider Active NPI

Mary K Lutz, OT

  • Occupational Therapist
  • Cincinnati, OH
National Provider Identifier
1750389904
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 02038 Issued in OH
Practice address
6909 Good Samaritan Drive
Suite a
Cincinnati, OH 45247-5207
Phone
(513) 245-5434
Fax
(513) 245-5424
NPI assigned
Jul 12, 2005
Last updated
Dec 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT 02038 OH Primary

Addresses

Primary practice location

6909 Good Samaritan Drive
Suite a
Cincinnati, OH 45247-5207

Mailing address

4701 Creek Rd
Suite 110
Cincinnati, OH 45242-8398
Phone (513) 733-9333

Other identifiers 2

IdentifierTypeStateIssuer
000000328340OtherOHANTHEM
2507086MedicaidOH

Other names 1

  • Mrs. Mary Kris Lutz Professional name

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

State licenses

LicenseStateTypeSpecialty
OT 02038OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Consultants of Cincinnati, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mary.lutz.p1@direct.beaconortho.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1750389904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 CREEK RD",
            "address_2": "SUITE 110",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452428398",
            "telephone_number": "513-733-9333",
            "fax_number": "513-588-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6909 GOOD SAMARITAN DRIVE",
            "address_2": "SUITE A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452475207",
            "telephone_number": "513-245-5434",
            "fax_number": "513-245-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "MARY",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT 02038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000328340",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2507086",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LUTZ",
            "middle_name": "KRIS",
            "prefix": "MRS.",
            "credential": "OT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.