NPIMap

Individual provider Active NPI

Jared Allan Sutton, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Fort Gordon, GA
National Provider Identifier
1104119403
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
10182 Issued in SD
Practice address
300 Hospital Road
Emergency Department
Fort Gordon, GA 30905-5650
Phone
(605) 520-1755
NPI assigned
May 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 27102 NE
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 10182 SD Primary

Addresses

Primary practice location

300 Hospital Road
Emergency Department
Fort Gordon, GA 30905-5650

Mailing address

353 Fairmont Blvd
Intensive Care Unit
Rapid City, SD 57701
Phone (605) 520-1755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200429001723 SD Practitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 0244522589 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Sanford School of Medicine of University of South Dakota, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Rapid City Hospital IncGroup PAC ID 6002729506, 560 clinicians
Prairie Lakes Health Care System IncGroup PAC ID 8628987823, 111 clinicians

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-1000

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000

Hospital & facility affiliations

  • Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077
  • Prairie Lakes Healthcare System, Inc Hospital, Watertown, SD, CCN 430005
  • Monument Health Spearfish Hospital Hospital, Spearfish, SD, CCN 430048

Merit-based Incentive Payment System (MIPS)

Final score
94.59 of 100Reported as group
Quality
100
Promoting interoperability
96
Improvement activities
40
Cost
85.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29636MNMDFamily Medicine Physician
10182SDMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Lakes Health Care System Inc CurrentSince Mar 24, 2020 Accepting new patients
Vibra Physicians LLC CurrentSince Feb 11, 2024 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Jan 12, 2022 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Jan 12, 2022 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince Mar 24, 2020 Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

2115 Promise Rd
Rapid City, SD 57701
Phone (605) 646-6040

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

Organizations & group practices 6

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1104119403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "INTENSIVE CARE UNIT",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-520-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL ROAD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "605-520-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "JARED",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-18",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "27102",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SD",
            "license": "10182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gordon, GA

Sources for this page

Verify at the official NPI Registry.