Active NPI
Mark W Stutz, M.D.
- Medical Oncology Physician
- Vincennes, IN
National Provider Identifier
1861420499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- License
- 01031197A
- Practice address
- 520 S 7TH St
Vincennes, IN 47591-1038 - Phone
- (812) 886-6565
- Fax
- (812) 886-6566
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Oncology Physician | 207RX0202X | R6F02 | MO | |
| Hematology & Oncology Physician | 207RH0003X | R6F02 | MO | |
| Medical Oncology Physician | 207RX0202X | 01031197A | IN | Primary |
Addresses
Primary practice location
520 S 7TH St
Vincennes, IN 47591-1038
Mailing address
520 S 7TH St
Vincennes, IN 47591-1038
Phone (812) 886-6565
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202377933 | Medicaid | MO | |
| 200922220 | Medicaid | IN | |
| 262813100 | Other | IN | TAX ID |
| 43-1823174 | Other | MO | TAX IDENTIFICATION NUMBER |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R6F02 | MO | MD | Hematology & Oncology Physician |
| 01031197A | IN | MD | Medical Oncology Physician |
Interoperability endpoints
- mstutz122343@direct.deaconess.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427328000000",
"number": "1861420499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 S 7TH ST",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475911038",
"telephone_number": "812-886-6565",
"fax_number": "812-886-6566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 S 7TH ST",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475911038",
"telephone_number": "812-886-6565",
"fax_number": "812-886-6566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUTZ",
"first_name": "MARK",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2015-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "MO",
"license": "R6F02",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "MO",
"license": "R6F02",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "IN",
"license": "01031197A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202377933",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200922220",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "262813100",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "43-1823174",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vincennes, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.