Individual provider Active NPI

David A Sutton, P.A. - C

  • Physician Assistant
  • Naperville, IL
National Provider Identifier
1083685572
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-001486 Issued in IL
Practice address
2940 Rollingridge Rd
Suite 201
Naperville, IL 60564-4231
Phone
(630) 967-6000
Fax
(630) 428-3971
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-001486 IL Primary

Addresses

Primary practice location

2940 Rollingridge Rd
Suite 201
Naperville, IL 60564-4231

Mailing address

2940 Rollingridge Rd
Suite 201
Naperville, IL 60564-4231
Phone (630) 967-6000

Other identifiers 1

IdentifierTypeStateIssuer
970025829OtherRAILROAD MEDICARE

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

LicenseStateTypeSpecialty
085-001486ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medventures Medical LLC Past Accepting new patients
Olson Chiropractic, Inc. PastSince Nov 1, 2006 Accepting new patients
Foxland Respiratory Consultants, S.C. Past Accepting new patients

Organizations & group practices 3

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1083685572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 ROLLINGRIDGE RD",
            "address_2": "SUITE 201",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644231",
            "telephone_number": "630-967-6000",
            "fax_number": "630-428-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 ROLLINGRIDGE RD",
            "address_2": "SUITE 201",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644231",
            "telephone_number": "630-967-6000",
            "fax_number": "630-428-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "P.A. - C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970025829",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.