Individual provider Active NPI

Victor Cutillo, DPT

  • Physical Therapist
  • Shelbyville, TN
National Provider Identifier
1881233799
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12429 Issued in TN
Practice address
105 Northside Park Dr
Shelbyville, TN 37160-2062
Phone
(931) 735-6451
Fax
(931) 735-6453
NPI assigned
Dec 26, 2019
Last updated
Dec 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12429 TN Primary

Addresses

Primary practice location

105 Northside Park Dr
Shelbyville, TN 37160-2062

Mailing address

PO Box 681478
Franklin, TN 37068-1478
Phone (615) 591-6590

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250519000300 TN Practitioner - Physical Therapist in Private Practice 6709268329

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1300 W Sam Houston Pkwy S
Suite 300
Houston, TX 77042-2453

PO Box
Franklin, TN 37068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12429TNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1881233799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681478",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681478",
            "telephone_number": "615-591-6590",
            "fax_number": "615-591-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 NORTHSIDE PARK DR",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602062",
            "telephone_number": "931-735-6451",
            "fax_number": "931-735-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTILLO",
        "first_name": "VICTOR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-26",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.