Active NPI
Lesa Sue Sutton-Davis, M.D.
- Pediatrics Physician
- Henderson, KY
National Provider Identifier
1396743258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 36607
- Practice address
- 2000 N Elm St Ste 1B
Henderson, KY 42420-2385 - Phone
- (270) 844-8144
- Fax
- (270) 844-8145
- NPI assigned
- Jul 13, 2005
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 36607 | KY | Primary |
Addresses
Primary practice location
2000 N Elm St Ste 1B
Henderson, KY 42420-2385
Mailing address
PO Box 638706
Cincinnati, OH 45263-8706
Phone (270) 827-7558
Other practice location 1
4420 Dixie Hwy
Suite 126
Louisville, KY 40216-2988
Phone (502) 810-3780
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000910700 | Other | KY | ANTHEM - NCMA |
| 170480 | Other | KY | SIHO-NCMA |
| 50086973 | Other | KY | PASSPORT - NCMA FAIRDALE |
| 50086969 | Other | KY | PASSPORT - NCMA BRECKENRIDGE |
| 64027493 | Medicaid | KY |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 371 | KY | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1396743258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 638706",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452638706",
"telephone_number": "270-827-7558",
"fax_number": "270-827-7530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 N ELM ST STE 1B",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424202385",
"telephone_number": "270-844-8144",
"fax_number": "270-844-8145"
}
],
"practiceLocations": [
{
"address_1": "4420 Dixie Hwy",
"address_2": "Suite 126",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402162988",
"country_code": "US",
"telephone_number": "502-810-3780",
"fax_number": "502-394-3607",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUTTON-DAVIS",
"first_name": "LESA",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-13",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "36607",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM - NCMA",
"identifier": "000000910700",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIHO-NCMA",
"identifier": "170480",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT - NCMA FAIRDALE",
"identifier": "50086973",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT - NCMA BRECKENRIDGE",
"identifier": "50086969",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64027493",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Henderson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.