DR. JACOB SUDDUTH MD
NPI 1821790593
Student in an Organized Health Care Education/Training Program in Port St Lucie, FL
About Dr. Jacob Sudduth Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACOB SUDDUTH MD (NPI 1821790593) is an individual student in an organized health care education/training program in Port St Lucie, Florida and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jacob Sudduth Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
PORT ST LUCIE, FL 34952
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacob Sudduth's NPI number?
The NPI number for Jacob Sudduth is 1821790593. It was assigned to this individual provider in the NPPES registry on March 20, 2023.
Where is Jacob Sudduth located?
Jacob Sudduth practices at 1800 SE Tiffany Ave, Port St Lucie, FL 34952. The listed phone number is (772) 335-4000.
What is Jacob Sudduth's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jacob Sudduth enrolled in Medicare?
Yes. Jacob Sudduth is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jacob Sudduth was last updated on March 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Dr. Jacob Sudduth, MD · NPI 1821790593
Student in an Organized Health Care Education/Training Program provider in Port St Lucie, Florida. Individual provider, active in the CMS NPPES registry since March 20, 2023.
## Identity
- **NPI:** 1821790593 (Entity type: Individual)
- **Enumerated:** March 20, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1800 SE TIFFANY AVE, Port St Lucie, FL 34952-7521
- **Phone:** (772) 335-4000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 20, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1821790593) · Data from the CMS NPPES public registry.