Active NPI
Suthon Chatkupt, M.D.
- Surgery Physician
- Excelsior Springs, MO
National Provider Identifier
1467436626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 33979
- Practice address
- 1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182 - Phone
- (816) 629-2743
- Fax
- (816) 629-2708
- NPI assigned
- Dec 1, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 33979 | MO | Primary |
Addresses
Primary practice location
1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182
Mailing address
1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182
Phone (816) 629-2743
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3127327007 | Other | CIGNA | |
| 4035241 | Other | AETNA | |
| 200236933 | Medicaid | MO | |
| 1042753 | Other | ECFMG | |
| 431726195 | Other | TAX ID | |
| 100240 | Other | FIRST GUARD | |
| 10270 | Other | MO | BUNN |
| 17080111 | Other | UNITED HEALTH CARE | |
| 36553 | Other | FIRST HEALTH | |
| 709912 | Other | KS | BLUE CROSS BLUE SHIELD |
| 021577062 | Other | RAILROAD MEDICARE | |
| 10001311700 | Other | COMMUNITY HEALTH | |
| 301800 | Other | FAMILY HEALTH PARTNERS | |
| 00297056 | Other | BLUE CROSS BLUE SHIELD | |
| 33825 | Other | HEALTHCARE USA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1467436626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 RAINBOW BLVD",
"city": "EXCELSIOR SPRINGS",
"state": "MO",
"postal_code": "640241182",
"telephone_number": "816-629-2743",
"fax_number": "816-629-2708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 RAINBOW BLVD",
"city": "EXCELSIOR SPRINGS",
"state": "MO",
"postal_code": "640241182",
"telephone_number": "816-629-2743",
"fax_number": "816-629-2708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHATKUPT",
"first_name": "SUTHON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-01",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "33979",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3127327007",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4035241",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200236933",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ECFMG",
"identifier": "1042753",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "431726195",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST GUARD",
"identifier": "100240",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUNN",
"identifier": "10270",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "17080111",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "36553",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "709912",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "021577062",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY HEALTH",
"identifier": "10001311700",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FAMILY HEALTH PARTNERS",
"identifier": "301800",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00297056",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE USA",
"identifier": "33825",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Excelsior Springs, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.