NPIMap

Individual provider Active NPI

J David Sule, MD

  • Urology Physician
  • Nephi, UT
National Provider Identifier
1437130515
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
14001511-1235 Issued in UT
Practice address
48 W 1500 N
Nephi, UT 84648-8900
Phone
(435) 623-3200
NPI assigned
Nov 7, 2005
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 042458 GA
Urology Physician 208800000X 14001511-1235 UT Primary

Addresses

Primary practice location

48 W 1500 N
Nephi, UT 84648-8900

Mailing address

98 Poplar St
Blackfoot, ID 83221
Phone (208) 758-4100

Other identifiers 1

IdentifierTypeStateIssuer
000718891AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805001972 UT Practitioner - Urology 6709892839 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Loma Linda University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Valley Medical CenterGroup PAC ID 2668380460, shared by 5 NPIs, 25 clinicians

Practice addresses (Care Compare)

48 W 1500
Nephi, UT 84648-8900
Phone (435) 623-3200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042458GAMDSpecialist
14001511-1235UTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valdosta Urological Associates Specialist CurrentSince Aug 1, 1996 Accepting new patients
Central Valley Medical Center Current Accepting new patients
Central Valley Medical Center Single Specialty CurrentSince Jul 22, 2024 Accepting new patients

Locations

3543 N Crossing Cir
Valdosta, GA 31602
Phone (229) 244-1736

48 W 1500 N
Nephi, UT 84648
Phone (435) 623-3000

210 E Main St
Santaquin, UT 84655
Phone (801) 373-2499

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1437130515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "83221",
            "telephone_number": "208-758-4100",
            "fax_number": "208-782-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 W 1500 N",
            "city": "NEPHI",
            "state": "UT",
            "postal_code": "846488900",
            "telephone_number": "435-623-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULE",
        "first_name": "J",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "042458",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "14001511-1235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000718891A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nephi, UT

Sources for this page

Verify at the official NPI Registry.