John Sutherland Barry, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

44643 Issued in MN

Practice address

1111 Highway 73
Moose Lake, MN 55767

Phone

(218) 565-6283

Fax

(651) 431-7631

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Minnesota Sex Offender Program

  • Psychiatric Residential Treatment Facility
  • Moose Lake, MN
  • NPI 1730354549
  NPD (past)
• State of Minnesota

  • Psychiatric Residential Treatment Facility
  • Moose Lake, MN
  • NPI 1639355902
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1023095874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 HIGHWAY 73",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "55767",
            "telephone_number": "218-565-6283",
            "fax_number": "651-431-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HIGHWAY 73",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "55767",
            "telephone_number": "218-565-6283",
            "fax_number": "651-431-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY",
        "first_name": "JOHN",
        "middle_name": "SUTHERLAND",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "44643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "771183200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Augustana Mercy Care Center LLC
• Augustana Mercy Care Center LLC
• Augustana Oakview Care, LLC
• Kristina Bailey
• Sharyn Barney, M.D.
• Bruce A. Beaman, LMFT
• Brianna D Bentley, DPT
• Josie Benzie
• Kathy H. Brandli, M.D.
• Blake Steven Chapman, DO

• All providers in Moose Lake, MN
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.