Individual provider Active NPI

William Vanmeter Sudduth IV, PA-C

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1225043730
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA684 Issued in KY
Practice address
800 Rose St
Lexington, KY 40536-7001
Phone
(859) 323-0295
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA684 KY Primary

Addresses

Primary practice location

800 Rose St
Lexington, KY 40536-7001

Mailing address

900 S Limestone Ctw320
Lexington, KY 40536-0200

Other practice location 1

1720 Nicholasville Rd Ste 400
Lexington, KY 40503-1475
Phone (859) 277-5887 ext. 7601

Other identifiers 2

IdentifierTypeStateIssuer
950025800MedicaidKY
970023737OtherKYRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wsudduth8971@bhkydirect.com

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100421000895 KY Practitioner - Physician Assistant 5890822902 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

908 Memorial CT
Suite 302
Elizabethtown, KY 42701-2525
Phone (270) 979-2583

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA684KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Dec 8, 2017 Accepting new patients
Baptist Health Medical Group Inc Physician Assistant CurrentSince Jan 1, 2015 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jan 1, 2015 Accepting new patients
Scully and Jones, PSC Current Accepting new patients

Locations

908 Memorial Ct
Ste 302
Elizabethtown, KY 42701
Phone (270) 979-2583

1002 Leawood Dr
Frankfort, KY 40601
Phone (502) 227-7188

1001 Leawood Dr
Ste A
Frankfort, KY 40601
Phone (502) 227-1871

200 Medical Dr
Ste 2A
Hazard, KY 41701
Phone (606) 439-4433

740 S Limestone
Lexington, KY 40536
Phone (859) 257-3533

1720 Nicholasville Rd
Ste 601
Lexington, KY 40503
Phone (859) 971-4652

800 Rose St
Ste 601
Lexington, KY 40536

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

1720 Nicholasville Rd
Ste 400
Lexington, KY 40503
Phone 8592775887 ext. 7601

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

991 Medical Park Dr
Ste 107
Maysville, KY 41056
Phone (606) 759-5437

154 Bogle Office Park Dr
Somerset, KY 42503
Phone (606) 677-2460

226 Medical Plaza Ln
Whitesburg, KY 41858
Phone (606) 633-4871

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1225043730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S LIMESTONE CTW320",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405367001",
            "telephone_number": "859-323-0295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 Nicholasville Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405031475",
            "country_code": "US",
            "telephone_number": "859-277-5887 x7601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUDDUTH",
        "first_name": "WILLIAM",
        "middle_name": "VANMETER",
        "name_suffix": "IV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "950025800",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970023737",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wsudduth8971@bhkydirect.com",
            "affiliation": "N",
            "address_1": "1720 Nicholasville Rd Ste 400",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405031475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.