JUSTIN SUTTON SUTTON (NPI# 1629267992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629267992 |
| Entity Type | Individual |
| Full Name | JUSTIN SUTTON SUTTON |
| Credential | IDC |
| Practice Address |
201 Kings Pond Dr Jacksonville NC 28546-7054 |
| Practice Telephone | 9104506109 |
| Mailing Telephone | 9104506109 |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2007-10-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215408638 | Justin Davon Sutton | Technician | 640 Audrey Ln Apt 102, Oxon Hill, MD 20745-4626 | 2018-12-11 |
| Street Address |
201 KINGS POND DR |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-7054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639793748 | Johnathon T Brewer | Military Health Care Provider | 100 White St, Jacksonville, NC 28540 | 2020-06-04 |
| 1740803725 | Alanna Gonzalez | Military Health Care Provider | 1453 Lindseys Crossing Dr, Jacksonville, FL 32218-8088 | 2020-05-25 |
| 1538793849 | Alberto Kris Cipollone | Military Health Care Provider | Bon Homme Richard Ave Bldg 2480, Jacksonville, FL 32246-0046 | 2020-02-25 |
| 1376175794 | James Ernest Claypool | Military Health Care Provider | 12411 Glenn Hollow Dr, Jacksonville, FL 32226-2349 | 2020-02-05 |
| 1316584543 | Christina Koch | Military Health Care Provider | 104 Eagle River Ct, Jacksonville, NC 28540-7745 | 2019-12-06 |
| 1174043244 | Jason Waters | Military Health Care Provider | White St, Bldg As-100, Jacksonville, NC 28540 | 2017-06-21 |
| 1023546108 | Gregory Donald Willden | Military Health Care Provider | Bon Homme Richard St, Bldg 2480, Jacksonville, FL 32228 | 2017-06-01 |
| 1285179077 | Bill Lee Todd Davis | Military Health Care Provider | 1151 Murrill Hill Rd, Jacksonville, NC 28540-8662 | 2017-01-03 |
| 1235681545 | Huriel A Rivera Aponte | Military Health Care Provider | Naval Station Mayport, Surflant Medical Readiness Division Detachment Mayport, Jacksonville, FL 32228 | 2016-11-03 |
| 1659727444 | Michael Phoenix Mcfarland | Military Health Care Provider | 898 Enterprise St Unit A, Jacksonville, FL 32227-1202 | 2016-05-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.