Individual provider Active NPI

Lydia Ann Sutherlun, MD

  • Internal Medicine Physician
  • Temple, TX
National Provider Identifier
1346567237
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P3459 Issued in TX
Practice address
2401 S 31St St
Internal Medicine Department (4 West)
Temple, TX 76508-0001
Phone
(254) 724-0454
NPI assigned
May 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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 P3459 TX Primary

Addresses

Primary practice location

2401 S 31St St
Internal Medicine Department (4 West)
Temple, TX 76508-0001

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-8800

Other names 1

  • Lydia Ann Seing Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsutherlun14736@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130819000734 TX Practitioner - Internal Medicine 4587806682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P3459TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients
Scott & White Clinic Internal Medicine Current Accepting new patients
Scott and White Clinic Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
Scott & White Memorial Hospital Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2401 S 31st St
#4W
Temple, TX 76508
Phone (254) 724-0454

Organizations & group practices 5

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 2

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": "1272672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1346567237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "address_2": "INTERNAL MEDICINE DEPARTMENT (4 WEST)",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLUN",
        "first_name": "LYDIA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-01",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P3459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsutherlun14736@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 S 31st St",
            "address_2": "Internal Medicine Department (4 west)",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765080001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LYDIA",
            "last_name": "SEING",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.