Active NPI
Caitlin Suckow, RN
- Dermatology Physician
- West Lafayette, IN
National Provider Identifier
1376418244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 1026230
- Practice address
- 915 Sagamore Pkwy W
West Lafayette, IN 47906-1443 - Phone
- (765) 463-9979
- Fax
- (765) 463-9979
- NPI assigned
- Oct 9, 2025
- 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 1026230 | IN | Primary |
Addresses
Primary practice location
915 Sagamore Pkwy W
West Lafayette, IN 47906-1443
Mailing address
652 Gainsboro Dr
West Lafayette, IN 47906-8891
Phone (765) 414-4409
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1026230 | IN | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759968000000",
"number": "1376418244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "652 GAINSBORO DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479068891",
"telephone_number": "765-414-4409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 SAGAMORE PKWY W",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479061443",
"telephone_number": "765-463-9979",
"fax_number": "765-463-9979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUCKOW",
"first_name": "CAITLIN",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-10-09",
"last_updated": "2025-10-09",
"certification_date": "2025-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IN",
"license": "1026230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.