Active NPI
Kelsey Tatum Sutherland, DPT
- Physical Therapist
- Sierra Vista, AZ
National Provider Identifier
1992304190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 31508
- Practice address
- 2151 S Highway 92 Ste 106
Sierra Vista, AZ 85635-5283 - Phone
- (520) 335-1615
- NPI assigned
- Oct 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 31508 | AZ | Primary |
Addresses
Primary practice location
2151 S Highway 92 Ste 106
Sierra Vista, AZ 85635-5283
Mailing address
3289 Thunderbird Dr
Sierra Vista, AZ 85650-6675
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31508 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1603152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603152000000",
"number": "1992304190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3289 THUNDERBIRD DR",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856506675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2151 S HIGHWAY 92 STE 106",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856355283",
"telephone_number": "520-335-1615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTHERLAND",
"first_name": "KELSEY",
"middle_name": "TATUM",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-20",
"last_updated": "2020-10-20",
"certification_date": "2020-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "31508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sierra Vista, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.