Active NPI
James A Sutphen, PA-C
- Medical Physician Assistant
- Omaha, NE
National Provider Identifier
1043230287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 1218
- Practice address
- 3410 N 156TH St
Omaha, NE 68116-2020 - Phone
- (402) 614-1258
- Fax
- (402) 614-5733
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 1218 | NE | Primary |
Addresses
Primary practice location
3410 N 156TH St
Omaha, NE 68116-2020
Mailing address
7261 Mercy Rd
Omaha, NE 68124-2311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38050 | Other | NE | BCBS |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1218 | NE | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Creighton Clinic | Medical | Past | Accepting new patients |
Interoperability endpoints
- jsutphen37966@achce.catholichealth.net
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513641600000",
"number": "1043230287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7261 MERCY RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681242311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3410 N 156TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681162020",
"telephone_number": "402-614-1258",
"fax_number": "402-614-5733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTPHEN",
"first_name": "JAMES",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2017-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NE",
"license": "1218",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "38050",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.