Staci Sutton

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA09194 Issued in TX

Practice address

7630 N Beach St Ste 140
Fort Worth, TX 76137-3016

Phone

(817) 281-2977

Fax

(817) 788-2530

NPI assigned

Jun 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: staci.sutton.1@15777.direct.athenahealth.com

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.

• Texas Health Action

  • Public Health & General Preventive Medicine Physician
  • Austin, TX
  • NPI 1366266363
  Medicare reassignment

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1043625296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7630 N BEACH ST STE 140",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761373016",
            "telephone_number": "817-281-2977",
            "fax_number": "817-788-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7630 N BEACH ST STE 140",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761373016",
            "telephone_number": "817-281-2977",
            "fax_number": "817-788-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "STACI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Leigh Sutherland
• Jennifer Sutherland, PTA,CLT
• Laura R Sutterer, CPNP
• Karen Renee Sutton, LPA
• Katherine Suzanne Sutton, F.N.P.
• Suvekchya Subedi, PLLC
• Ashley Svetlik, PA
• SVS Psychiatry PLLC
• SW FW Mental Health , PLLC
• Deborah Jane Swagerty

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.