Individual provider Active NPI

Damon Suttle

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1821786393
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023005751 Issued in AZ
Practice address
6130 N la Cholla Blvd Ste 117
Tucson, AZ 85741-3589
Phone
(520) 742-4159
NPI assigned
Apr 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2023005751 AZ Primary

Addresses

Primary practice location

6130 N la Cholla Blvd Ste 117
Tucson, AZ 85741-3589

Mailing address

5055 E Broadway Blvd Ste A100
Tucson, AZ 85711-3629
Phone (520) 327-0460

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240202003016 AZ Practitioner - Nurse Practitioner 2466895768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pain Institute of Southern Arizona Pisa PC 23 clinicians
Arizona Community Physicians PC 162 clinicians

Practice addresses (Care Compare)

4881 E Grant Rd
Tucson, AZ 85712-2704
Phone (520) 829-6776

6130 N la Cholla Blvd
Suite 100
Tucson, AZ 85741-3589
Phone (520) 742-4159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2023005751AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Institute of Southern Arizona Pisa PC CurrentSince Oct 1, 2025 Accepting new patients
Pain Institute of Southern Arizona Pisa PC CurrentSince Oct 1, 2025 Accepting new patients
Arizona Community Physicians PC Nurse Practitioner CurrentSince Feb 1, 2024 Accepting new patients
Arizona Community Physician PC CurrentSince Feb 1, 2024 Accepting new patients
Tucson Specialty Labs LLC PastSince Apr 1, 2023 Accepting new patients
Arizona Medical Specialty Group, LLC Family PastSince Apr 1, 2023 Accepting new patients

Locations

6130 N La Cholla Blvd
Ste 117
Tucson, AZ 85741
Phone (520) 207-7434

4881 E Grant Rd
Tucson, AZ 85712
Phone (520) 829-6776

4582 N 1st Ave
Ste 170
Tucson, AZ 85718
Phone (520) 505-3766

4881 E Grant Rd
Ste 101
Tucson, AZ 85712
Phone (520) 829-6776

6130 N La Cholla Blvd
Ste 100
Tucson, AZ 85741
Phone (520) 742-4159

5055 E Broadway Blvd
Ste A100
Tucson, AZ 85711
Phone (520) 327-0460

2055 W Hospital Dr
Tucson, AZ 85704
Phone (520) 547-5725

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72783

Organizations & group practices 8

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": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1821786393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 E BROADWAY BLVD STE A100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113629",
            "telephone_number": "520-327-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 N LA CHOLLA BLVD STE 117",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413589",
            "telephone_number": "520-742-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTLE",
        "first_name": "DAMON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-24",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "2023005751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.