MARK R KUTYLA DPM PA (NPI# 1720032816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720032816 |
| Entity Type | Organization |
| Organization Name | MARK R KUTYLA DPM PA |
| Other Organization Name | MIDLANDS FOOT CLINIC |
| Practice Address |
121 Park Place Ct Lexington SC 29072-6690 |
| Practice Telephone | 8033564712 |
| Practice Fax Number | 8033560832 |
| Mailing Telephone | 8033564712 |
| Mailing Fax Number | 8033560832 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2011-11-06 |
| Authorized Official Name | DR. MARK R KUTYLA (PRESIDENT) |
| Authorized Official Telephone | 8033564712 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | Y |
| Parent Organization Name | MARK R KUTYLA DPM PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ER0200X |
Podiatrist Specialization: Radiology |
516 | SC | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0000X |
Podiatrist Specialization: Sports Medicine |
516 | SC | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
516 | SC | Podiatric Medicine & Surgery Service Providers |
| N | 2471M1202X |
Radiologic Technologist Specialization: Magnetic Resonance Imaging |
516 | SC | Technologists, Technicians & Other Technical Service Providers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 516 | SC | Suppliers |
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
516 | SC | Suppliers |
| N | 335E00000X | Prosthetic/Orthotic Supplier | 516 | SC | Suppliers |
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
516 | SC | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | CLIA CERTIFICATE OF WAIVER | 42D2021725 | 01 |
| SC | AETNA PROVIDER NO. | 7238051 | 01 |
| SC | ACM # MIDLANDS FOOT CL. | 1020003 | 01 |
| Other Name | Type Code |
|---|---|
| MIDLANDS FOOT CLINIC | Doing Business As Name - Organization |
| Street Address |
121 PARK PLACE CT |
| City | LEXINGTON |
| State | SC |
| Zip Code | 29072-6690 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326007022 | Mark Raymond Kutyla | Podiatrist | 121 Park Place Ct, Lexington, SC 29072-6690 | 2006-03-21 |
| 1871191080 | Lexington Health Inc | Podiatrist | 121 Park Place Ct, Lexington, SC 29072-6690 | 2020-10-12 |
| 1568854602 | Lexington County Health Services District, Inc. | Podiatrist | 121 Park Place Ct, Lexington, SC 29072-6690 | 2015-02-26 |
| 1578525820 | Paul Richard Bearden | Podiatrist | 121 Park Place Ct, Lexington, SC 29072-6690 | 2006-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484821 | Grace Physicians Services | Clinic/Center | 1483 Old Cherokee Road, Lexington, SC 29072 | 2020-10-12 |
| 1750995007 | Trinity Health and Wellness | Clinic/Center | 1483 Old Cherokee Rd, Lexington, SC 29072 | 2020-09-03 |
| 1730727629 | Erika Watts | Occupational Therapist | 100 Tarrar Springs Road, Sped, Lexington, SC 29072 | 2019-12-11 |
| 1194380600 | Lexington County Health Services District, Inc. | Clinic/Center | 154 Saluda Pointe Ct, Lexington, SC 29072 | 2019-05-09 |
| 1962973768 | William R. Key | Counselor | Lexington Community Mental Health Center, 301 Palmetto Park Boulevard, Lexington, SC 29072 | 2018-12-06 |
| 1639651961 | Lindsey Terry | Social Worker | 108 Palmetto Pk. Boulveard, Suite D, Lexington, SC 29072 | 2018-09-04 |
| 1922594126 | Dental Professional of South Carolina, P.C. | Dentist | 2448 Augusta Hwy, Lexington, SC 29072 | 2018-07-11 |
| 1598251605 | Lynn Marceline Beckett-lowe | Nurse Practitioner | 124 Pink Camellia Lane, Lexington, SC 29072 | 2018-07-02 |
| 1083120620 | Diana Reiss | Counselor | 714 S Lake Drive, 120, Lexington, SC 29072 | 2017-12-19 |
| 1649781857 | Constance Jean Lynch | Occupational Therapist | 800 North Lake Boulevard, Lexington, SC 29072 | 2017-10-14 |
| Find all providers in zip 29072 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326007022 | Mark Raymond Kutyla | Podiatrist | 121 Park Place Ct, Lexington, SC 29072-6690 | 2006-03-21 |
| 1194045369 | Dpmpkirkpr Pllc | Podiatrist | 249 W Church St, Lexington, TN 38351-2013 | 2010-06-10 |
| 1053579532 | James B Braudis Dpm Plc | Podiatrist | 1236 Gainesway Dr, Lexington, KY 40517-2813 | 2008-05-30 |
| 1376575969 | Patricia A Kirk | Podiatrist | 270 W Church St, Suite D, Lexington, TN 38351-2077 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457728032 | Flowertown Podiatry, Inc | Podiatrist | 4340 Ladson Rd Ste C, Ladson, SC 29456-6444 | 2015-08-30 |
| 1346384971 | John Ksor | Podiatrist | 2502 Broad St, Camden, SC 29020-2238 | 2007-02-16 |
| 1669441895 | Gerard F Rainer | Podiatrist | 148 Milestone Way, Suite A, Greenville, SC 29615-5007 | 2006-03-17 |
| 1609850122 | Brad A. Lindstrom | Podiatrist | 211 E Butler Rd, Suite A-2, Mauldin, SC 29662-2169 | 2005-11-30 |
| 1285623827 | Sarah M Jordan | Podiatrist | 1399 John B White Sr Blvd, Spartanburg, SC 29306-3911 | 2005-10-17 |
| 1194259341 | Matthew Fernandez | Podiatrist | 1012 Physicians Dr, Charleston, SC 29414-5719 | 2017-04-14 |
| 1134571334 | Robert Ezewuiro | Podiatrist | 1190 Highway 9 Byp W, Lancaster, SC 29720-1709 | 2016-07-12 |
| 1336564749 | Oak Tree Podiatry, Pa | Podiatrist | 5 Winchester Ct, Mauldin, SC 29662-2626 | 2014-02-21 |
| 1265673784 | Hans Blaakman,dpm,llc | Podiatrist | 1575 E Main St, Duncan, SC 29334-9218 | 2009-03-12 |
| 1467609016 | Gerard F. Rainer Dpm | Podiatrist | 148 Milestone Way, Ste A, Greenville, SC 29615-5007 | 2008-08-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.