Active NPI
Tina Sudduth
- Family Nurse Practitioner
- Tuscaloosa, AL
National Provider Identifier
1316360084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1-046361
- Practice address
- 809 University Blvd E
Tuscaloosa, AL 35401-2029 - Phone
- (205) 759-7803
- Fax
- (205) 343-8029
- NPI assigned
- Jan 30, 2014
- Last updated
- Jan 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-046361 | AL | Primary |
Addresses
Primary practice location
809 University Blvd E
Tuscaloosa, AL 35401-2029
Mailing address
12775 Frank Lary Rd
Northport, AL 35475-4713
Phone (205) 339-6187
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)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-046361 | AL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391040000000",
"number": "1316360084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12775 FRANK LARY RD",
"city": "NORTHPORT",
"state": "AL",
"postal_code": "354754713",
"telephone_number": "205-339-6187",
"fax_number": "205-339-9535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 UNIVERSITY BLVD E",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354012029",
"telephone_number": "205-759-7803",
"fax_number": "205-343-8029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUDDUTH",
"first_name": "TINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-30",
"last_updated": "2014-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "1-046361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuscaloosa, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.