Physician Compare National (NPI:1336132802)

HEALTHCARE PROVIDER: JOSHUA PRICE SUTHERLAND JR. DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1336132802
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5092812479
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070518000397
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SUTHERLAND
	Individual professional last name
Provider First Name	JOSHUA
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RIVERSIDE MEDICAL CLINIC INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4789902354
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	20886 RIVERSIDE DR
	Group Practice or individual's line 1 address
City	GRUNDY
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	246149597
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2769357515
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	180044
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PIKEVILLE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y