Individual provider Active NPI

Issac Ira Surridge

  • Adult Companion
  • Elm Creek, NE
National Provider Identifier
1336004811
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Practice address
220 S Beecroft St
Elm Creek, NE 68836-7701
Phone
(308) 746-9663
NPI assigned
Dec 17, 2025
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X NU Primary

Addresses

Primary practice location

220 S Beecroft St
Elm Creek, NE 68836-7701

Mailing address

220 S Beecroft St
Elm Creek, NE 68836-7701

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1765929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1336004811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S BEECROFT ST",
            "city": "ELM CREEK",
            "state": "NE",
            "postal_code": "688367701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S BEECROFT ST",
            "city": "ELM CREEK",
            "state": "NE",
            "postal_code": "688367701",
            "telephone_number": "308-746-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURRIDGE",
        "first_name": "ISSAC",
        "middle_name": "IRA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elm Creek, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.