Individual provider Active NPI

Jennifer Lynn Sutphin, OTRL

  • Speech-Language Pathologist
  • Dunn, NC
National Provider Identifier
1174611545
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4222 Issued in NC
Practice address
1100 S Clinton Avenue
Ste C
Dunn, NC 28334
Phone
(910) 892-0027
Fax
(910) 892-0029
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4222 NC
Occupational Therapist 225X00000X 4222 NC
Speech-Language Pathologist 235Z00000X 4222 NC Primary

Addresses

Primary practice location

1100 S Clinton Avenue
Ste C
Dunn, NC 28334

Mailing address

1100 S Clinton Avenue
Ste C
Dunn, NC 28334
Phone (910) 892-0027

Other identifiers 1

IdentifierTypeStateIssuer
7211634MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4222NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Therapy Services Inc Physical Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1174611545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S CLINTON AVENUE",
            "address_2": "STE C",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "28334",
            "telephone_number": "910-892-0027",
            "fax_number": "910-892-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S CLINTON AVENUE",
            "address_2": "STE C",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "28334",
            "telephone_number": "910-892-0027",
            "fax_number": "910-892-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTPHIN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "4222",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "4222",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "4222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211634",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.