Active NPI
Paul Randolph Tuthill, DC
- Chiropractor
- Grand Rapids, MI
National Provider Identifier
1962444075
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Feb 18, 2010.
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- PT002903
- Practice address
- 1425 Bridge St NW
Suite # 501
Grand Rapids, MI 49504-1702 - Phone
- (616) 866-8644
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | PT002903 | MI | Primary |
Addresses
Primary practice location
1425 Bridge St NW
Suite # 501
Grand Rapids, MI 49504-1702
Mailing address
1425 Bridge NW
Suite # 501
Grand Rapids, MI 49504
Phone (616) 884-8644
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2870924 | Medicaid | MI |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT002903 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271116800000",
"number": "1962444075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 BRIDGE NW",
"address_2": "SUITE # 501",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49504",
"telephone_number": "616-884-8644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 BRIDGE ST NW",
"address_2": "SUITE # 501",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495041702",
"telephone_number": "616-866-8644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUTHILL",
"first_name": "PAUL",
"middle_name": "RANDOLPH",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2010-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "PT002903",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2870924",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.