Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACK DOUGLAS SUDDUTH MD, MS
NPI 1215632898
Emergency Medicine in Charleston, SC

Q: What is Jack Sudduth's NPI number?

The NPI number for Jack Sudduth is 1215632898. It was assigned to this individual provider in the NPPES registry on April 3, 2023.

Q: What is Jack Sudduth's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Sudduth was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 03, 2023PECOS Enrolled

169 ASHLEY AVE RM 202, CHARLESTON, SC 29425(843) 876-6983 Get Directions Write a Review

NPPES record last updated: August 26, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 26, 2026, Aug 1, 2026, Apr 3, 2023 (3 updates tracked since 2023).

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About Jack Douglas Sudduth Md, Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK DOUGLAS SUDDUTH MD, MS (NPI 1215632898) is an individual emergency medicine provider in Charleston, South Carolina, licensed in South Carolina (97057) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215632898

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameJACK DOUGLAS SUDDUTHCredential: MD, MS

Location Address169 ASHLEY AVE RM 202Charleston, SC 29425-8905

Mailing Address169 Ashley Ave Rm 202Charleston, SC 29425-8905

Phone(843) 876-6983

Sole ProprietorYes

Enumeration DateApril 3, 2023

Last NPPES UpdateAugust 26, 20263 updates tracked since enumeration

NPPES CertifiedAugust 26, 2026

✔ NPI 1215632898 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in SC · 97057

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Also ListedAnesthesiology · Critical Care MedicineTaxonomy 207LC0200X · License 97057 (SC)

169 ASHLEY AVE RM 202, Charleston, SC 29425

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Douglas Sudduth Md, Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29425 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANAA ABDELMAGEED MD

Surgery