Pamela Sutherly, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50-00-1250 Issued in OH

Practice address

700 S Stanfield Rd Ste a
Troy, OH 45373

Phone

(937) 339-5355

Fax

(937) 339-3056

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Homecare Home health agency, Kettering, OH, CCN 367778
• Kettering Health Troy Hospital, Troy, OH, CCN 360368
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Upper Valley Medical Center Hospital, Troy, OH, CCN 360174
• Wayne Hospital Hospital, Greenville, OH, CCN 361335
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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

• Alliance Physicians Inc

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment Care Compare group NPD
• Alliance Physicians Inc

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Centerville, OH
  • NPI 1013256981
  NPD
• Mercy Health Physicians Cincinnati LLC

  • Durable Medical Equipment & Medical Supplies
  • Liberty Township, OH
  • NPI 1790281517
  NPD
• Mercy Health Physicians Cincinnati, LLC

  • Family Medicine Physician
  • Blue Ash, OH
  • NPI 1205887023
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alternate Solutions Homecare of Dayton, LLC

  • Home Health Agency
  • Kettering, OH
  • NPI 1639195332
  Care Compare affiliation
• Dayton Osteopathic Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Kettering Medical Center

  • General Acute Care Hospital
  • Troy, OH
  • NPI 1023587045
  Care Compare affiliation
• Kettering Medical Center

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Upper Valley Medical Center

  • General Acute Care Hospital
  • Troy, OH
  • NPI 1184638942
  Care Compare affiliation
• Wayne Hospital Company

  • Critical Access Hospital
  • Greenville, OH
  • NPI 1184621161
  Care Compare affiliation

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1487792867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S STANFIELD RD STE A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453732569",
            "telephone_number": "937-339-5355",
            "fax_number": "937-339-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S STANFIELD RD STE A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "45373",
            "telephone_number": "937-339-5355",
            "fax_number": "937-339-3056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Looney Rd",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Piqua",
            "state": "OH",
            "postal_code": "45356",
            "country_code": "US",
            "telephone_number": "937-615-9051",
            "fax_number": "937-615-9053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 Looney Rd",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Piqua",
            "state": "OH",
            "postal_code": "45356",
            "country_code": "US",
            "telephone_number": "937-615-9051",
            "fax_number": "937-615-9053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 Looney Rd",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Piqua",
            "state": "OH",
            "postal_code": "45356",
            "country_code": "US",
            "telephone_number": "937-615-9051",
            "fax_number": "937-615-9053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHERLY",
        "first_name": "PAMELA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50-00-1250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160410",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "psutherly575713@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "700 S Stanfield Rd Ste A",
            "city": "Troy",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "700 S Stanfield Rd Ste A",
            "city": "Troy",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Stull, NP
• Megan Stumpff
• Kathleen Sturgeon
• Suk-Wan Lee MD LLC
• Tina L Supinger, LSW
• Scott W Swabb, D.O.
• Kathryn Grayce Swanberg, M.A. CF-SLP
• Tiffany Tiara Swank
• Kimberly Lee-Ann Swartz, RN
• Katie Elizabeth Swint, LCSW

• Medical Physician Assistant in Troy, OH
• Providers in Troy, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.