Individual provider Active NPI

Sutapa Ford, PHD

  • Psychologist
  • Durham, NC
National Provider Identifier
1376615641
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3006 Issued in NC
Practice address
6114 Fayetteville Rd Ste 109
Durham, NC 27713-6284
Phone
(919) 942-4424
Fax
(919) 942-4440
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3006 NC Primary

Addresses

Primary practice location

6114 Fayetteville Rd Ste 109
Durham, NC 27713-6284

Mailing address

6114 Fayetteville Rd Ste 109
Durham, NC 27713-6284
Phone (919) 942-4424

Other identifiers 1

IdentifierTypeStateIssuer
SUTAPA FORDN/A1376MedicaidNC

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3006NCMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1376615641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6114 FAYETTEVILLE RD STE 109",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136284",
            "telephone_number": "919-942-4424",
            "fax_number": "919-942-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6114 FAYETTEVILLE RD STE 109",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136284",
            "telephone_number": "919-942-4424",
            "fax_number": "919-942-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "SUTAPA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUTAPA FORDN/A1376",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.