Marykelly Sutton, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G76932 Issued in CA

Practice address

9801 Fair Oaks Blvd
Suite 300
Fair Oaks, CA 95628-7012

Phone

(916) 671-1780

NPI assigned

Oct 12, 2006

Last updated

Dec 23, 2013By the provider in NPPES

Sex

Female

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

Opted out of Medicare

Previously, effective Oct 1, 2012 through Oct 1, 2026

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1770672230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 FAIR OAKS BLVD",
            "address_2": "SUITE 300",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287012",
            "telephone_number": "916-671-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 FAIR OAKS BLVD",
            "address_2": "SUITE 300",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287012",
            "telephone_number": "916-671-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "MARYKELLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G76932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.