Individual provider Active NPI

Jennefer Carl Sutton, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1790776276
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M2137 Issued in TX
Practice address
3503 Paesanos Pkwy Ste 101
San Antonio, TX 78231-1225
Phone
(210) 492-8922
Fax
(210) 479-2010
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M2137 TX Primary

Addresses

Primary practice location

3503 Paesanos Pkwy Ste 101
San Antonio, TX 78231-1225

Mailing address

3503 Paesanos Pkwy Ste 101
San Antonio, TX 78231-1225
Phone (210) 492-8922

Other identifiers 3

IdentifierTypeStateIssuer
341526702MedicaidTX
341526703OtherTXCSHCN
341526701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070209000291 TX Practitioner - Family Practice 3678575305 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network Family Medicine CurrentSince Nov 3, 2014 Accepting new patients
Health by Design Medical Group CurrentSince Jul 31, 2023 Accepting new patients
C H Wilkinson Physician Network CurrentSince Nov 3, 2014 Accepting new patients
Lone Star Primary Care and Aesthetics Family Medicine PastSince Jul 2, 2007 Accepting new patients

Locations

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

3503 Paesanos Pkwy
Ste 101
San Antonio, TX 78231
Phone (210) 492-8922

13409 George Rd
San Antonio, TX 78230
Phone (210) 345-4855

4118 Pond Hill Rd
Ste 202
Shavano Park, TX 78231
Phone (210) 450-6620

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: jennefer.sutton@546238333255684.direct.elationemr.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1790776276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3503 PAESANOS PKWY STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311225",
            "telephone_number": "210-492-8922",
            "fax_number": "210-479-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3503 PAESANOS PKWY STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311225",
            "telephone_number": "210-492-8922",
            "fax_number": "210-479-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "JENNEFER",
        "middle_name": "CARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M2137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341526702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "341526703",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341526701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.