Active NPI
Laura Sutherland
- Family Nurse Practitioner
- Kingsport, TN
National Provider Identifier
1336517119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 20220
- Practice address
- 1101 E Stone Dr
Kingsport, TN 37660-3384 - Phone
- (423) 224-1110
- Fax
- (423) 224-1130
- NPI assigned
- Sep 10, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 20220 | TN | Primary |
Addresses
Primary practice location
1101 E Stone Dr
Kingsport, TN 37660-3384
Mailing address
1101 E Stone Dr
Kingsport, TN 37660-3384
Phone (423) 224-1110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160908000956 | TN | Order and Referring Only - Nurse Practitioner | 6406142025 |
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": "1441843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487894400000",
"number": "1336517119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 E STONE DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603384",
"telephone_number": "423-224-1110",
"fax_number": "423-224-1130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 E STONE DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603384",
"telephone_number": "423-224-1110",
"fax_number": "423-224-1130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTHERLAND",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-10",
"last_updated": "2017-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "20220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.