Individual provider Active NPI

Laura R Sutterer, CPNP

  • Pediatric Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1881045482
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
745999 Issued in TX
Practice address
801 7TH Ave
Fort Worth, TX 76104-2733
Phone
(682) 885-1475
Fax
(682) 885-7520
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 745999 TX Primary

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104-2733

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsutterer17303@CookChildrens.direct-ci.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240510001975 TX Practitioner - Nurse Practitioner 8527409333 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
745999TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Current Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

4100 W University Dr
Prosper, TX 75078
Phone (682) 303-4200

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: lsutterer17303@cookchildrens.direct-ci.com

Organizations & group practices 2

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": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1881045482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042733",
            "telephone_number": "682-885-1475",
            "fax_number": "682-885-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTERER",
        "first_name": "LAURA",
        "middle_name": "R",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "745999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsutterer17303@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "801 7th Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.