David Wayne Suetholz, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18013 Issued in KY

Practice address

2378 Grandview Dr
Fort Mitchell, KY 41017-1633

Phone

(859) 341-1122

Fax

(859) 341-1171

NPI assigned

Apr 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1811950256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2378 GRANDVIEW DR",
            "city": "FORT MITCHELL",
            "state": "KY",
            "postal_code": "410171633",
            "telephone_number": "859-341-1122",
            "fax_number": "859-341-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2378 GRANDVIEW DR",
            "city": "FORT MITCHELL",
            "state": "KY",
            "postal_code": "410171633",
            "telephone_number": "859-341-1122",
            "fax_number": "859-341-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUETHOLZ",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "18013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64180136",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280360",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Stone
• Mackenzie Stone
• Anne Kathleen Storrs
• Rebecca Stoudt
• Ryan Michael Subler, O.D.
• Michaela Therese Summe
• Bhargavi Tangirala, MD
• Benjamin Taylor, BCBA, LBA
• Cheryl Lynn Taylor, LCSW
• Steven W Teufel, D.C.

• Family Medicine Physician in Fort Mitchell, KY
• Providers in Fort Mitchell, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.