Individual provider Active NPI

Jacob Josiah Sutton, D.O.

  • Internal Medicine Physician
  • Muskogee, OK
National Provider Identifier
1285995977
Registry record updated Jul 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5446 Issued in OK
Practice address
1011 Honor Heights Dr
Muskogee, OK 74401
Phone
(918) 577-3509
NPI assigned
May 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5446 OK Primary

Addresses

Primary practice location

1011 Honor Heights Dr
Muskogee, OK 74401

Mailing address

3613 S Yorktown PL
Tulsa, OK 74105-3451
Phone (918) 706-1324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20210629001899 AR Practitioner - Internal Medicine 6608178991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

2710 S Rife Medical LN
Rogers, AR 72758-1452

Hospital & facility affiliations

  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
  • Mercy Hospital Berryville Hospital, Berryville, AR, CCN 041329
  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities CurrentSince Jun 7, 2021 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jun 7, 2021 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

Organizations & group practices 2

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 3

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": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532217600000",
    "number": "1285995977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 S YORKTOWN PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741053451",
            "telephone_number": "918-706-1324",
            "fax_number": "918-706-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "74401",
            "telephone_number": "918-577-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "JACOB",
        "middle_name": "JOSIAH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-30",
        "last_updated": "2018-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "5446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.