Individual provider Active NPI

James Noland Suddeth, M.D.

  • Family Medicine Physician
  • Ship Bottom, NJ
National Provider Identifier
1992812275
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA050043 Issued in NJ
Practice address
1812 Long Beach Blvd
Ship Bottom, NJ 08008-4443
Phone
(609) 494-2323
Fax
(609) 494-4141
NPI assigned
Aug 24, 2006
Last updated
Jul 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA050043 NJ Primary

Addresses

Primary practice location

1812 Long Beach Blvd
Ship Bottom, NJ 08008-4443

Mailing address

1812 Long Beach Blvd
Ship Bottom, NJ 08008-4443
Phone (609) 494-2323

Other identifiers 1

IdentifierTypeStateIssuer
6175708MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20101023000103 NJ Practitioner - Family Practice 6103953799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Maryland School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Medical Professional AssociationGroup PAC ID 4981731569, 3 clinicians

Practice addresses (Care Compare)

1812 Long Beach Blvd
Ship Bottom, NJ 08008-4443
Phone (609) 494-2323

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA050043NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Island Medical Professional Association Family Medicine CurrentSince Jan 1, 1989 Accepting new patients

Locations

1812 Long Beach Blvd
Ship Bottom, NJ 08008
Phone (609) 226-3007

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1992812275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 LONG BEACH BLVD",
            "city": "SHIP BOTTOM",
            "state": "NJ",
            "postal_code": "080084443",
            "telephone_number": "609-494-2323",
            "fax_number": "609-494-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 LONG BEACH BLVD",
            "city": "SHIP BOTTOM",
            "state": "NJ",
            "postal_code": "080084443",
            "telephone_number": "609-494-2323",
            "fax_number": "609-494-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDETH",
        "first_name": "JAMES",
        "middle_name": "NOLAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA050043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6175708",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ship Bottom, NJ

Sources for this page

Verify at the official NPI Registry.