Justin Daniel Sudbeck, APRN, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1084140 Issued in TX

Practice address

1866 Keller Pkwy Ste B
Keller, TX 76248-3763

Phone

(682) 337-3810

NPI assigned

Jun 10, 2022

Sex

Male

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

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsudbeck1208169@direct.sw.org
• Direct secure messaging: justin.sudbeck.1@7537.direct.athenahealth.com
• FHIR API: https://fhir4.healow.com/fhir/r4/DCIGCD

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.

• 360 Cardiac Care PC

  • Interventional Cardiology Physician
  • North Richland Hills, TX
  • NPI 1801555784
  Medicare reassignment NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1114657418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 N KNOWLES DR",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761791024",
            "telephone_number": "682-208-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 KELLER PKWY STE B",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483763",
            "telephone_number": "682-337-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDBECK",
        "first_name": "JUSTIN",
        "middle_name": "DANIEL",
        "credential": "APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1084140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Diane Strub, O.D.
• Corey Nicholas Strunk, DC
• Vanessa Stuart
• Susan L Stumm, MS/ABD, CCC-SLP
• Kyndra Sturdivant
• Sugar N Spice Total Body Wellness Spa (Sugar N Spice And All Of You Are Ni)
• Superior Lifestyles Assisted Living
• Support Space Therapy and Wellness, PLLC
• Support Space Therapy and Wellness, PLLC
• Omini Surapaneni, B.PHARM

• Acute Care Nurse Practitioner in Keller, TX
• Providers in Keller, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.