Organization Active NPI

Sutton Orthopaedics & Sports Medicine PC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Fayetteville, GA
National Provider Identifier
1124165964
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
SUTTON ORTHOPAEDICS & SPORTS MEDICINE PC
Practice address
500 W Lanier Ave
Suite 506
Fayetteville, GA 30214-7636
Phone
(770) 389-8386
Fax
(770) 507-9576
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Authorized official

Name
Joseph Carl Sutton Jr., M.D.
Title
President
Phone
(770) 389-8386

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

500 W Lanier Ave
Suite 506
Fayetteville, GA 30214-7636

Mailing address

145 Medical Blvd
Stockbridge, GA 30281-5083
Phone (770) 389-8386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426000297 GA Part B Supplier - Clinic/Group Practice 2466448295 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fayetteville, GA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sutton Orthopaedics Sports Medicine PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1124165964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 MEDICAL BLVD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815083",
            "telephone_number": "770-389-8386",
            "fax_number": "770-507-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W LANIER AVE",
            "address_2": "SUITE 506",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147636",
            "telephone_number": "770-389-8386",
            "fax_number": "770-507-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTON ORTHOPAEDICS & SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-389-8386",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.