Individual provider Active NPI

Christian P. Sutherlin, MD

  • Student in an Organized Health Care Education/Training Program
  • Wpafb, OH
National Provider Identifier
1336087535
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Phone
(937) 522-2778
NPI assigned
Mar 23, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH Primary
Military Health Care Provider 171000000X OH

Addresses

Primary practice location

4881 Sugar Maple Dr
Wpafb, OH 45433-5529

Mailing address

4881 Sugar Maple Dr
Wpafb, OH 45433
Phone (602) 882-4782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20260618002124 OH Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2860964046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1336087535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WPAFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "602-882-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WPAFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-522-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLIN",
        "first_name": "CHRISTIAN",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wpafb, OH

Sources for this page

Verify at the official NPI Registry.