Samuel Keith Suttle, M.D.
Individual provider Active NPI Family Medicine Physician · Louisville, MS
NPI 1497705453 · NPPES record last updated Mar 10, 2020
Key facts
- NPI
- 1497705453
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 08435 (MS)
- Practice address
- 14724 Highway 15 N
Louisville, MS 39339-6318 - Phone
- (662) 773-7500
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Mississippi School of Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Choctaw Regional Medical Center
Practice addresses (Care Compare)
14724 Hwy 15 N
Louisville, MS 39339-6318
Phone (662) 285-9460
8613 Ms Hwy 12
Ackerman, MS 39735-8917
Phone (662) 285-9460
Hospital & facility affiliations
- Accentcare Home Health of Carthage
- Mississippi Homecare of Eupora
- Quality Hospice Care, Inc
- Choctaw Regional Medical Center
- Winston Medical Center
- BMH-Golden Triangle
- Winston County Nursing Home
- Louisville Healthcare LLC
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.39 of 100
- Quality
- 65.98
- Improvement activities
- 40
- Cost
- 74.48
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091207000030 | MS | Practitioner - Family Practice | 8022012475 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Winston County Medical Foundation | Current |
Accepting new patients | |
| Choctaw Regional Medical Center | Family Medicine | Current |
Accepting new patients |
| Winston County Medical Foundation | Past | Accepting new patients |
Locations
8613 MS Highway 12
Ackerman, MS 39735
Phone (662) 285-4400
14724 Highway 15 N
Louisville, MS 39339
Phone (662) 773-7500
17550 E Main St
Louisville, MS 39339
Phone (662) 446-1072
Interoperability endpoints
- samuel.suttle.1@15070.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 08435 | MS | Yes |
Addresses
Primary practice location
14724 Highway 15 N
Louisville, MS 39339-6318
Mailing address
8613 Ms Highway 12
Ackerman, MS 39735-8917
Phone (662) 285-9460
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00119309 | Medicaid | MS |
Other providers in Louisville, MS
- Stenen C Yarbrough DMD
- Linda Darlene Strickland
- Tiffany Strickland
- Valerie O'Briant Sullivan
- Superior Smiles, LLC
- Tabor Drugs, Inc.
- Mary M Tabor
- Rekeka Tate
- Stephanie Taylor
- The Columbus Orthopaedic Clinic, P.a.
All providers in Louisville, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.