Active NPI
Justin Davon Sutton, PERMIT TO CARRY GUN
- Personal Care Attendant
- Oxon Hill, MD
National Provider Identifier
1215408638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 640 Audrey LN Apt 102
Oxon Hill, MD 20745-4626 - Phone
- (202) 487-1204
- NPI assigned
- Dec 11, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
640 Audrey LN Apt 102
Oxon Hill, MD 20745-4626
Mailing address
640 Audrey LN Apt 102
Oxon Hill, MD 20745-4626
Phone (202) 487-1204
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CPR | Medicaid | DC | |
| 99-500540 | Other | VA | PERMIT TO CARRY A HANDGUN VA |
| 2356696 | Medicaid | DC | |
| 438-95732 | Other | MD | PERMIT TO CARRY A HANDGUN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544486400000",
"number": "1215408638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 AUDREY LN APT 102",
"city": "OXON HILL",
"state": "MD",
"postal_code": "207454626",
"telephone_number": "202-487-1204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 AUDREY LN APT 102",
"city": "OXON HILL",
"state": "MD",
"postal_code": "207454626",
"telephone_number": "202-487-1204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTON",
"first_name": "JUSTIN",
"middle_name": "DAVON",
"credential": "PERMIT TO CARRY GUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-11",
"last_updated": "2018-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CPR",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERMIT TO CARRY A HANDGUN VA",
"identifier": "99-500540",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2356696",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERMIT TO CARRY A HANDGUN",
"identifier": "438-95732",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oxon Hill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.