Active NPI
Meredith Hutton
- Physical Therapist
- Shiloh, IL
National Provider Identifier
1972907970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2014026915
- Practice address
- 1901 Frank Scott Pkwy E
Shiloh, IL 62269-7342 - Phone
- (618) 624-7077
- NPI assigned
- Oct 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2014026915 | MO | Primary |
| Physical Therapist | 225100000X | 070.021135 | IL |
Addresses
Primary practice location
1901 Frank Scott Pkwy E
Shiloh, IL 62269-7342
Mailing address
236 Sandridge CT
Collinsville, IL 62234-3715
Other names 1
- Meredith Clarkston
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.021135 | IL | MD | Physical Therapist |
| 2014026915 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413763200000",
"number": "1972907970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "236 SANDRIDGE CT",
"city": "COLLINSVILLE",
"state": "IL",
"postal_code": "622343715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 FRANK SCOTT PKWY E",
"city": "SHILOH",
"state": "IL",
"postal_code": "622697342",
"telephone_number": "618-624-7077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTTON",
"first_name": "MEREDITH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-20",
"last_updated": "2014-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2014026915",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.021135",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MEREDITH",
"last_name": "CLARKSTON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Shiloh, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.