Individual provider Active NPI

Jorgen Spafford Sumsion, MD

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1760132021
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R80164 Issued in AZ
Practice address
13400 E Shea Blvd
Phoenix, AZ 85054
Phone
(480) 515-6296
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X R80164 AZ Primary

Addresses

Primary practice location

13400 E Shea Blvd
Phoenix, AZ 85054

Mailing address

800 Rose Street, MN 275
Lexington, KY 40536-0293

Other practice location 1

800 Rose Street, MN 275
Lexington, KY 40536-0293
Phone (859) 323-6162

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsumsion1950756@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230519002000 AZ Order and Referring Only - AnesthesiologyPractitioner - Anesthesiology 3779949516

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Utah School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5001 LBJ Fwy
Suite 320
Dallas, TX 75244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1760132021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROSE STREET, MN 275",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85054",
            "telephone_number": "480-515-6296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose Street, MN 275",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360293",
            "country_code": "US",
            "telephone_number": "859-323-6162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMSION",
        "first_name": "JORGEN",
        "middle_name": "SPAFFORD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "R80164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsumsion1950756@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "85054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.