Individual provider Active NPI

Ralph Marc Sutherlin, D.O.

  • Family Medicine Physician
  • St Maries, ID
National Provider Identifier
1245291772
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-264 Issued in ID
Practice address
622 W College Ave Ste 2
St Maries, ID 83861-1822
Phone
(208) 568-7800
Fax
(877) 902-7131
NPI assigned
Apr 2, 2006
Last updated
Feb 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-264 ID Primary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X O-264 ID

Addresses

Primary practice location

622 W College Ave Ste 2
St Maries, ID 83861-1822

Mailing address

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081223000505 ID Practitioner - Emergency Medicine 7214099340 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Harvard Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Syringa Health and Wellness LLCGroup PAC ID 5395124622, 3 clinicians

Practice addresses (Care Compare)

1745 Main Ave
St Maries, ID 83861-1238
Phone (208) 582-3145

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
O-264IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Idaho Day Surgery LLC CurrentSince Feb 1, 2026 Accepting new patients
Benewah Medical Center CurrentSince May 31, 2022 Accepting new patients
Syringa Health and Wellness, PLLC CurrentSince Aug 1, 2024 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Family Medicine Past Accepting new patients

Locations

427 12th St
Plummer, ID 83851
Phone (208) 686-1449

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

750 N Syringa St
Ste 100
Post Falls, ID 83854
Phone (208) 262-2600

622 W College Ave
#2
St Maries, ID 83861
Phone (208) 245-4363

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1143936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1245291772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2498",
            "fax_number": "208-262-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W COLLEGE AVE STE 2",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838611822",
            "telephone_number": "208-568-7800",
            "fax_number": "877-902-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLIN",
        "first_name": "RALPH",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-02",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-264",
            "primary": true
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "ID",
            "license": "O-264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Maries, ID

Sources for this page

Verify at the official NPI Registry.