Organization Active NPI

Kathleen P Hutton MD Inc

  • Dermatology Physician
  • Newport Beach, CA
National Provider Identifier
1962598300
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
KATHLEEN P HUTTON MD INC
Practice address
1441 Avocado Ave
Suite 309
Newport Beach, CA 92660
Phone
(949) 644-8556
Fax
(949) 644-6318
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Authorized official

Name
Mrs. Kathleen P Hutton, MDNPI 1164518593
Title
President Owner
Phone
(949) 644-8556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1441 Avocado Ave
Suite 309
Newport Beach, CA 92660

Mailing address

1441 Avocado Ave
Suite 309
Newport Beach, CA 92660
Phone (949) 644-8556

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ564182OtherCABLUE SHIELD OF CALIFORNIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040709001393 CA Part B Supplier - Clinic/Group Practice 7315925922 Receives reassigned benefits from 3 practitioners
Practice locations: Newport Beach, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0870989Kathleen Hutton MD, Inc1441 Avocado Ave, Ste 309, Newport Beach, CA 92660ComplianceOct 21, 2027

National Provider Directory

National Provider Directory

Locations

1441 Avocado Ave
Ste 309
Newport Beach, CA 92660
Phone (949) 644-8556

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1962598300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 AVOCADO AVE",
            "address_2": "SUITE 309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-644-8556",
            "fax_number": "949-644-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 AVOCADO AVE",
            "address_2": "SUITE 309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-644-8556",
            "fax_number": "949-644-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN P HUTTON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "HUTTON",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "949-644-8556",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ564182",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.