Justin Sutton Sutton, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

201 Kings Pond Dr
Jacksonville, NC 28546-7054

Phone

(910) 450-6109

NPI assigned

Oct 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1629267992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 KINGS POND DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467054",
            "telephone_number": "910-450-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 KINGS POND DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467054",
            "telephone_number": "910-450-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "JUSTIN",
        "middle_name": "SUTTON",
        "credential": "IDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Summerlin, LPCA
• Nicole Summerlin, PTA
• Suncoast Medical, PC
• Tyra Sundquist, RN
• Katherine Price Sutherland, FNP-C
• Edward Swailes, P.A.
• Nikki Rose Swailes, PA-C
• Ashtin Swaim, DPT
• Jacqueline Swain
• Katrina S Swartz, PAC

• Independent Duty Corpsman in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Independent Duty Corpsman in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.