NPIMap

Organization Active NPI

Sutton Internal and Physical Medicine Clinic, Inc

  • Internal Medicine Physician
  • Niles, OH
National Provider Identifier
1386726214
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34-00-7547-S Issued in OH
Legal business name
SUTTON INTERNAL AND PHYSICAL MEDICINE CLINIC, INC
Practice address
1250 Youngstown Warren Rd
Sutie 1a
Niles, OH 44446-4649
Phone
(330) 544-1500
Fax
(330) 544-7988
NPI assigned
Oct 19, 2006
Last updated
Oct 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Authorized official

Name
Dr. Jeffrey Blaine Sutton, D.O.NPI 1477511939
Title
President
Phone
(330) 544-1500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 34-00-7547-S OH
Internal Medicine Physician 207R00000X 34-00-7547-S OH Primary

Addresses

Primary practice location

1250 Youngstown Warren Rd
Sutie 1a
Niles, OH 44446-4649

Mailing address

1250 Youngstown Warren Rd
Sutie 1a
Niles, OH 44446-4649
Phone (330) 544-1500

Other identifiers 1

IdentifierTypeStateIssuer
2378323MedicaidOH

National Provider Directory

National Provider Directory

Locations

1250 Youngstown Warren Rd
Ste 1A
Niles, OH 44446
Phone (330) 544-1500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1386726214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 YOUNGSTOWN WARREN RD",
            "address_2": "SUTIE 1A",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444464649",
            "telephone_number": "330-544-1500",
            "fax_number": "330-544-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 YOUNGSTOWN WARREN RD",
            "address_2": "SUTIE 1A",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444464649",
            "telephone_number": "330-544-1500",
            "fax_number": "330-544-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTON INTERNAL AND PHYSICAL MEDICINE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "BLAINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-544-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "OH",
            "license": "34-00-7547-S",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34-00-7547-S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2378323",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; 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.