Kathleen Sulentich, M.D./F.A.C.O.G.

Primary specialty

SpecialistTaxonomy code 174400000X

License

19781 Issued in MN

Practice address

307 1St St S
Suite 112
Virginia, MN 55792-2696

Phone

(218) 741-6221

Fax

(218) 741-2550

NPI assigned

May 10, 2006

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

Other identifiers 1

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown 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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1831149046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 13TH AVE E",
            "address_2": "SUITE 6",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557463675",
            "telephone_number": "218-263-7540",
            "fax_number": "866-732-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 1ST ST S",
            "address_2": "SUITE 112",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922696",
            "telephone_number": "218-741-6221",
            "fax_number": "218-741-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULENTICH",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D./F.A.C.O.G.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "19781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "29304SU",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Virginia, MN
• Providers in Virginia, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.