Individual provider Active NPI

Olivia Dutcher, PT, DPT

  • Neurology Physical Therapist
  • Mount Laurel, NJ
National Provider Identifier
1841035235
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology Physical TherapistTaxonomy code 2251N0400X
Practice address
523 Fellowship Rd Ste 290
Mount Laurel, NJ 08054-3418
Phone
(856) 424-5552
NPI assigned
Jun 27, 2024
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physical Therapist 2251N0400X NU Primary

Addresses

Primary practice location

523 Fellowship Rd Ste 290
Mount Laurel, NJ 08054-3418

Mailing address

523 Fellowship Rd Ste 290
Mount Laurel, NJ 08054-3418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715000042 NJ Practitioner - Physical Therapist in Private Practice 1759826795 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multiple Sclerosis Specialty Center Neurology CurrentSince Jun 24, 2024 Accepting new patients

Locations

523 Fellowship Rd
Ste 290
Mount Laurel, NJ 08054
Phone (856) 424-5552

9000 Midlantic Dr
Ste 101
Mount Laurel, NJ 08054
Phone (856) 424-5552

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": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1841035235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 FELLOWSHIP RD STE 290",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 FELLOWSHIP RD STE 290",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543418",
            "telephone_number": "856-424-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTCHER",
        "first_name": "OLIVIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.