Mindy Gray Sutton, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11002601 Issued in FL

Practice address

210 S Main St
Crestview, FL 32536-3737

Phone

(850) 226-6801

Fax

(877) 413-5104

NPI assigned

Jul 22, 2019

Last updated

Apr 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mindy Lee Gray Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1902459662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363737",
            "telephone_number": "850-306-3433",
            "fax_number": "877-413-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363737",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "MINDY",
        "middle_name": "GRAY",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261330",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105993400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINDY",
            "last_name": "GRAY",
            "middle_name": "LEE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tammy Suggs, RN
• Asha Sumrall
• Sunil Gupta MD LLC (Retina Specialty Institute)
• Sunil Gupta MD LLC (Retina Specialty Institute)
• Brittany Ann Surgner
• Michael Vincent Florendo Tablang, M.D.
• Sujika Tamang
• Nicholas Tambone
• Christopher D. Tanner, MD
• Joel A Tate, D.C.

• Family Nurse Practitioner in Crestview, FL
• Providers in Crestview, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.