Individual provider Active NPI

Cherilyn Ann Sudar, CNP

  • Family Nurse Practitioner
  • Irving, TX
National Provider Identifier
1093038069
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.09215-NP Issued in OH
Practice address
3050 Regent Blvd Ste 200
Irving, TX 75063-5806
Phone
(214) 689-8067
NPI assigned
Mar 5, 2010
Last updated
Nov 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.09215-NP OH Primary

Addresses

Primary practice location

3050 Regent Blvd Ste 200
Irving, TX 75063-5806

Mailing address

308 Township Road 581
Sullivan, OH 44880-9767
Phone (419) 736-3012

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
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.09215-NPOHMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1093038069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 TOWNSHIP ROAD 581",
            "city": "SULLIVAN",
            "state": "OH",
            "postal_code": "448809767",
            "telephone_number": "419-736-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 REGENT BLVD STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750635806",
            "telephone_number": "214-689-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDAR",
        "first_name": "CHERILYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-05",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.09215-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.