Individual provider Active NPI

Kyler Bridgeman Sudhoff

  • Physician Assistant
  • Boone, NC
National Provider Identifier
1508679481
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
232 Boone Heights Dr # a
Boone, NC 28607-4926
Phone
(828) 386-2663
NPI assigned
Jan 27, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

232 Boone Heights Dr # a
Boone, NC 28607-4926

Mailing address

232 Boone Heights Dr # a
Boone, NC 28607-4926
Phone (828) 386-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20250603002485 NC Practitioner - Physician Assistant 1951810746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appalachian Regional Medical Associates IncGroup PAC ID 5799877817, 147 clinicians

Practice addresses (Care Compare)

211 Milton Brown Heirs Rd
Boone, NC 28607-8708
Phone (828) 265-2159

232 Boone Heights Dr
Suite a
Boone, NC 28607-4926
Phone (828) 386-2663

336 Deerfield Rd
Boone, NC 28607-5008
Phone (828) 262-4100

Hospital & facility affiliations

  • Watauga Medical Center Hospital, Boone, NC, CCN 340051
  • Charles a Cannon Jr Memorial Hospital Hospital, Linville, NC, CCN 341323
  • Ashe Memorial Hospital Hospital, Jefferson, NC, CCN 341325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1508679481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 BOONE HEIGHTS DR # A",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074926",
            "telephone_number": "828-386-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 BOONE HEIGHTS DR # A",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074926",
            "telephone_number": "828-386-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDHOFF",
        "first_name": "KYLER",
        "middle_name": "BRIDGEMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

Verify at the official NPI Registry.