Individual provider Active NPI

Kristopher Ryan Sutherly, MD

  • Emergency Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1114246303
Registry record updated Apr 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q7971 Issued in TX
Practice address
600 Elizabeth St
Corpus Christi, TX 78404-2235
Phone
(361) 902-4100
NPI assigned
May 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q7971 TX Primary

Addresses

Primary practice location

600 Elizabeth St
Corpus Christi, TX 78404-2235

Mailing address

312 Peerman PL
Corpus Christi, TX 78411-1610
Phone (813) 362-8646

Other practice location 1

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone (210) 671-6557

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160620000643 TX Practitioner - Emergency Medicine 8224279518 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
East Tennessee State University Quillen College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Emergency Physicians, PLLCGroup PAC ID 6204280480, 108 clinicians

Practice addresses (Care Compare)

5950 Saratoga Blvd
Corpus Christi, TX 78414-4100
Phone (361) 985-5000

Hospital & facility affiliations

  • Christus Spohn Hospital Corpus Christi Hospital, Corpus Christi, TX, CCN 450046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Emergency Physicians, PLLC Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Jefferson Emergency Physicians, PLLC Emergency Medicine CurrentSince Oct 7, 2023 Accepting new patients
Conner Emergency Medicine Associates, PA Emergency Medicine CurrentSince Feb 15, 2018 Accepting new patients
Jefferson Emergency Medicine Associates PA Emergency Medicine CurrentSince Sep 4, 2022 Accepting new patients
Bexar Emergency Physicians, PLLC Emergency Medicine CurrentSince Mar 1, 2024 Accepting new patients
Guadalupe Emergency Medicine Associates, PA Emergency Medicine CurrentSince Mar 7, 2018 Accepting new patients
Nueces Emergency Medicine Associates PA Emergency Medicine CurrentSince Feb 1, 2019 Accepting new patients
Fastpass Ucdfw, PLLC Past Accepting new patients
Christus Spohn Health System Corporation Past Accepting new patients

Locations

2500 E Main St
Alice, TX 78332
Phone (361) 664-4376

2830 Calder St
Beaumont, TX 77702
Phone (409) 899-7000

1500 E Houston St
Beeville, TX 78102
Phone (361) 354-2000

2606 Hospital Blvd
Corpus Christi, TX 78405
Phone (361) 902-4151

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511

1311 Gen Cvazos Blvd
Kingsville, TX 78363
Phone (361) 595-1661

8801 9th Ave
Port Arthur, TX 77642
Phone (409) 299-3214

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

11130 Christus Hls
Ste 119
San Antonio, TX 78251
Phone (210) 703-9800

1434 E Sonterra Blvd
Ste 101
San Antonio, TX 78258
Phone (210) 686-8000

Organizations & group practices 9

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712966400000",
    "number": "1114246303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 PEERMAN PL",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111610",
            "telephone_number": "813-362-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ELIZABETH ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042235",
            "telephone_number": "361-902-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Wilford Hall Loop",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782365638",
            "country_code": "US",
            "telephone_number": "210-671-6557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHERLY",
        "first_name": "KRISTOPHER",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-27",
        "last_updated": "2024-04-13",
        "certification_date": "2024-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q7971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.