Glenn Carl Sutphin, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

121399 Issued in WV

Practice address

122 12TH St
Princeton, WV 24740-2312

Phone

(304) 487-7000

NPI assigned

Nov 12, 2024

Last updated

Dec 20, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Princeton Community Hospital Assn. Inc.Group PAC ID 3678482221, 174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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.

• Princeton Community Hospital Assn Inc.

  dba Mercer Medical Group

  • Urology Physician
  • Princeton, WV
  • NPI 1093917643
  Medicare reassignment Care Compare group NPD
• Princeton Community Hospital Assn., Inc

  dba Bluefield Internal Medicine

  • Rural Health Clinic/Center
  • Bluefield, VA
  • NPI 1235446485
  NPD

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

• Princeton Community Hospital Assn., Inc.

  • General Acute Care Hospital
  • Princeton, WV
  • NPI 1558313213
  Care Compare affiliation

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1235953613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 UNION DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247408822",
            "telephone_number": "304-921-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 12TH ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402312",
            "telephone_number": "304-487-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253022340",
            "country_code": "US",
            "telephone_number": "304-340-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTPHIN",
        "first_name": "GLENN",
        "middle_name": "CARL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "121399",
            "primary": true
        },
        {
            "code": "163WF0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Flight",
            "state": "WV",
            "license": "81976",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leeann Stroupe
• Yvette Ann Stroupe
• Jennifer Stull, RN
• Sunshine Pediatrics
• Jenna Sustaric
• Morgan Sutphin, BSW, MSW, LSW
• Sylvia a. Wright Dba Sunrise Counseling Services LLC
• T.L.Conklin, DDS, Inc. (TLC Dental Care)
• Talk It Up Therapy Services, Inc.
• Lakesha Tate

• Family Nurse Practitioner in Princeton, WV
• Providers in Princeton, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.