Active NPI
Terry F Sutterfield, M.D.
- Family Medicine Physician
- Springdale, AR
National Provider Identifier
1689679573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C6677
- Practice address
- 614 E Emma Ave
Suite 300
Springdale, AR 72764-4634 - Phone
- (479) 751-7417
- Fax
- (479) 751-4898
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 49304 | CO | |
| Family Medicine Physician | 207Q00000X | C6677 | AR | Primary |
Addresses
Primary practice location
614 E Emma Ave
Suite 300
Springdale, AR 72764-4634
Mailing address
614 E Emma Ave
Suite 300
Springdale, AR 72764-4634
Phone (479) 751-7417
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24202355 | Medicaid | CO | |
| 55127 | Other | AR | BLUE CROSS AR |
| 109686001 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080312000377 | AR | Practitioner - Family Practice | 8325123524 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C6677 | AR | MD | Family Medicine Physician |
| 49304 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Circle of Life | Family Medicine | Current | Accepting new patients |
| Boston Mountain Rural Health Center Inc | Past | Accepting new patients |
Locations
901 Jones Rd
Springdale, AR 72762
Phone (479) 750-6632
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.
-
- Federally Qualified Health Center (FQHC)
- Marshall, AR
- NPI 1720096027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1689679573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 E EMMA AVE",
"address_2": "SUITE 300",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727644634",
"telephone_number": "479-751-7417",
"fax_number": "479-751-4898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 E EMMA AVE",
"address_2": "SUITE 300",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727644634",
"telephone_number": "479-751-7417",
"fax_number": "479-751-4898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTERFIELD",
"first_name": "TERRY",
"middle_name": "F",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "49304",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "C6677",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "24202355",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS AR",
"identifier": "55127",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109686001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.