Andrea Jae Sudderth, HAD

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HADS001065 Issued in GA

Practice address

32 Johnson Dr
Braselton, GA 30517-2774

Phone

(770) 853-9206

NPI assigned

Dec 9, 2021

Last updated

Nov 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Andrea Jae Buitrago Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Magnolia Hearing Center

  • Hearing Instrument Specialist
  • Braselton, GA
  • NPI 1427823921
  NPD Authorized official

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1770242406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PAULA ST",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291626",
            "telephone_number": "706-870-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 JOHNSON DR",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305172774",
            "telephone_number": "770-853-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDERTH",
        "first_name": "ANDREA",
        "middle_name": "JAE",
        "credential": "HAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "GA",
            "license": "HADS001065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEARING AID DISPENSER",
            "identifier": "HADS001065",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA STATE LICENSE",
            "identifier": "HADS001065",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BUITRAGO",
            "middle_name": "JAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nina Rowe Stefanie, AGACNP-BC
• Rebekah Stegmayer, PA
• Ilisa Beth Stern, DMD
• Christine Stoutenburg, LPC
• Hannah Strong
• Crystal Suits, SA-C
• Maria Sulbaran, IBCLC
• Surgical Assisting by Carmen
• Reza H Sutandi, MD
• Rana Zouveenoor Tariq, M.D

• Hearing Instrument Specialist in Braselton, GA
• Providers in Braselton, GA by specialty
• Hearing Instrument Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.