Active NPI
Melissa Heather Sudduth, CRNP
- Family Nurse Practitioner
- Flourtown, PA
National Provider Identifier
1609257633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- SPO14806
- Practice address
- 1107 Bethlehem Pike
Suite 210
Flourtown, PA 19031-1919 - Phone
- (267) 440-2050
- Fax
- (267) 440-2060
- NPI assigned
- Jun 16, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SPO14806 | PA | Primary |
Addresses
Primary practice location
1107 Bethlehem Pike
Suite 210
Flourtown, PA 19031-1919
Mailing address
1107 Bethlehem Pike
Suite 210
Flourtown, PA 19031-1919
Phone (267) 440-2050
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CD4829 | Other | PA | TPI RAILROAD MEDICARE |
| 597586 | Other | PA | TPI MEDICARE |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SPO14806 | PA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Temple Physicians Inc | Past | Accepting new patients | |
| Temple Physicians Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Philadelphia, PA
- NPI 1164841946
-
- Family Medicine Physician
- Flourtown, PA
- NPI 1952642936
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440633600000",
"number": "1609257633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 BETHLEHEM PIKE",
"address_2": "SUITE 210",
"city": "FLOURTOWN",
"state": "PA",
"postal_code": "190311919",
"telephone_number": "267-440-2050",
"fax_number": "267-440-2060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 BETHLEHEM PIKE",
"address_2": "SUITE 210",
"city": "FLOURTOWN",
"state": "PA",
"postal_code": "190311919",
"telephone_number": "267-440-2050",
"fax_number": "267-440-2060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUDDUTH",
"first_name": "MELISSA",
"middle_name": "HEATHER",
"name_prefix": "Mrs.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-16",
"last_updated": "2015-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SPO14806",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TPI RAILROAD MEDICARE",
"identifier": "CD4829",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TPI MEDICARE",
"identifier": "597586",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flourtown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.