Douglas Gary Sutcliffe Jr., NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704271786 Issued in MI

Practice address

PO Box 328
South Range, MI 49963-0328

Phone

(906) 364-1359

NPI assigned

Jun 24, 2021

Last updated

Jan 8, 2026By the provider in NPPES

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lac Vieux Desert Band of Lake Superior Chippewa IndiansGroup PAC ID 2567629181, 16 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.23 of 100Reported as apm

Quality

76.64

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lac Vieux Desert Band of Lake Superior Chippewa Indians

  dba LVD Health Center

  • Federally Qualified Health Center (FQHC)
  • Watersmeet, MI
  • NPI 1114071578

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1205406063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 328",
            "city": "SOUTH RANGE",
            "state": "MI",
            "postal_code": "499630328",
            "telephone_number": "906-364-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 328",
            "city": "SOUTH RANGE",
            "state": "MI",
            "postal_code": "499630328",
            "telephone_number": "906-364-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTCLIFFE",
        "first_name": "DOUGLAS",
        "middle_name": "GARY",
        "name_suffix": "Jr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-24",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704271786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Braswell, RDN
• Sarah Lee Derenzo, D.C.
• Sarah Dowd, LPC
• Heidi Annette Sutcliffe, NP-C
• Vitlaity Chirorpactic and Wellness Inc

• Family Nurse Practitioner in South Range, MI
• Providers in South Range, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.