Individual provider Active NPI

Laddeus L Sutton, MD

  • Cardiovascular Disease Physician
  • Gastonia, NC
National Provider Identifier
1891793139
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
9300332 Issued in NC
Practice address
2555 Court Dr Ste 200
Gastonia, NC 28054-2178
Phone
(704) 868-3256
Fax
(704) 868-5870
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 9300332 NC Primary

Addresses

Primary practice location

2555 Court Dr Ste 200
Gastonia, NC 28054-2178

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Other identifiers 1

IdentifierTypeStateIssuer
N00332MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20071214000438 NC Practitioner - Cardiovascular Disease (Cardiology) 8426148487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Brody School of Medicine at East Carolina University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

1000 Caromont Pkwy
Belmont, NC 28012-0140
Phone (704) 834-2000

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

2555 Court Dr
Suite 200
Gastonia, NC 28054-2178
Phone (704) 867-2141

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc CurrentSince Jan 1, 2012 Accepting new patients
Caromont Medical Group Inc CurrentSince Jan 1, 2012 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc Past Accepting new patients

Locations

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

2555 Court Dr
Ste 200
Gastonia, NC 28054
Phone (704) 671-7670

2555 Court Dr
Ste 300
Gastonia, NC 28054
Phone (704) 834-3278

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1891793139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR STE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542178",
            "telephone_number": "704-868-3256",
            "fax_number": "704-868-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "LADDEUS",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "9300332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00332",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.