Individual provider Active NPI

Deeb Sudd, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • New Iberia, LA
National Provider Identifier
1114978855
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
14015R Issued in LA
Practice address
2315 E Main St
New Iberia, LA 70560-4031
Phone
(337) 374-7620
NPI assigned
May 15, 2006
Last updated
Jun 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 14015R LA Primary

Addresses

Primary practice location

2315 E Main St
New Iberia, LA 70560-4031

Mailing address

200 Corporate Blvd
Suite 201
Lafayette, LA 70508-3870

Other identifiers 1

IdentifierTypeStateIssuer
1439967MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20131204000029 NC Practitioner - Internal MedicinePractitioner - Emergency Medicine 8224941166 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC CurrentSince Jul 1, 2017 Accepting new patients
The Carolinas Emergency Group, PLLC CurrentSince Oct 1, 2015 Accepting new patients
Wilson Emergency Physician Partners PLLC CurrentSince Jun 1, 2015 Accepting new patients
Riverside Medical Center Past Accepting new patients
Correct Care, Inc. Past Accepting new patients
Louisiana Emergency Physicians, LLC Past Accepting new patients
Acs Primary Care Physicians Louisiana PC Past Accepting new patients
Riverside Medical Center Past Accepting new patients
Hospital Service District No. 2 Past Accepting new patients

Locations

200 Corporate Blvd
Ste 201
Lafayette, LA 70508

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

1705 Tarboro St SW
Wilson, NC 27893
Phone (252) 399-8040

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1114978855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E MAIN ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705604031",
            "telephone_number": "337-374-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDD",
        "first_name": "DEEB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "LA",
            "license": "14015R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1439967",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

Verify at the official NPI Registry.