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JODI R LUTZ NP NPI 1063996130


NPI Information

NPI: 1063996130
Provider Name: JODI R LUTZ, NP
Classification: Nurse Practitioner - 363L00000X
Entity Type: Individual
Organization: SSM MEDICAL GROUP INC

PECOS Registration: Yes

Address:
1650 WASHINGTON AVE
ALTON, IL
ZIP 62002
Phone: (314) 687-2735
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Jodi R Lutz, NP is a nurse practitioner in Alton, IL with 7 years of experience. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Jodi R Lutz, NP NPI is 1063996130. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2017

The provider's business location address is:

1650 WASHINGTON AVE
ALTON, IL
ZIP 62002-931
Phone: (314) 687-2735

The NPI 1063996130 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/24/2018 and was last updated on 10/23/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse Practitioner209017496ILLINOISYes
2363LF0000XNurse PractitionerFamily209017496ILLINOISNo
3363LF0000XNurse PractitionerFamily2018006031MISSOURINo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.