NPIMap

Organization Active NPI

The Sutherland Clinic LLC

  • Family Medicine Physician
  • Paris, MO
National Provider Identifier
1992800635
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
113731 Issued in MO
Legal business name
THE SUTHERLAND CLINIC LLC
Practice address
221 N Main St
Paris, MO 65275-1328
Phone
(660) 327-6416
Fax
(660) 327-6217
NPI assigned
Sep 14, 2006
Last updated
Jan 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Authorized official

Name
Dr. Charles Sutherland, DO
Title
Owner
Phone
(660) 327-6407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 113731 MO Primary

Addresses

Primary practice location

221 N Main St
Paris, MO 65275-1328

Mailing address

221 N Main St
PO Box 206
Paris, MO 65275-1328
Phone (660) 327-6416

Other identifiers 1

IdentifierTypeStateIssuer
245101407MedicaidMO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231113600000",
    "number": "1992800635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 N MAIN ST",
            "address_2": "PO BOX 206",
            "city": "PARIS",
            "state": "MO",
            "postal_code": "652751328",
            "telephone_number": "660-327-6416",
            "fax_number": "660-327-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 N MAIN ST",
            "city": "PARIS",
            "state": "MO",
            "postal_code": "652751328",
            "telephone_number": "660-327-6416",
            "fax_number": "660-327-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SUTHERLAND CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2009-01-05",
        "status": "A",
        "authorized_official_last_name": "SUTHERLAND",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-327-6407",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "113731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245101407",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.