Mary Josephine Sutherland, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2225 Issued in FL

Practice address

3189 US Highway 17
Fleming Island, FL 32003-7109

Phone

(904) 621-0247

Fax

(904) 339-9945

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Physician Assistant

State licenses

Practice roles

Locations

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.

• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597

  Physician Assistant

  Medicare reassignment NPD

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1912927237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3189 HIGHWAY 17",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320439371",
            "telephone_number": "904-621-0247",
            "fax_number": "904-339-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3189 US HIGHWAY 17",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320037109",
            "telephone_number": "904-621-0247",
            "fax_number": "904-339-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "MARY",
        "middle_name": "JOSEPHINE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2225",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA2225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291115900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer R Stewartz, OTR/L, MS
• Curtis Lawrence Storm, M.D.
• Ilyana Renee Strickland
• Strong Foundations Behavior Services
• Leah J Sturgeon, OTR/L
• Norma F Swagel
• Micaela Renee Swann
• Kristen N Sweeney, PA-C
• Lillie Elaine Switanek, LCSW
• Daniel Jahmyr-Samaj Sykes, LPTA

• Medical Physician Assistant in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.