DR. SAMUEL KEITH SUTTLE (M.D.) – Family Medicine Physician, NPI 1497705453
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
939 FAMILY PRACTICE in MS
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Provider Addresses for DR. SAMUEL KEITH SUTTLE (M.D.)
8613 MS HIGHWAY 12
ACKERMAN, MS 397358917
Phone: (662) 285-9460
Fax: (662) 285-9324
Type: Mailing
N, Administration Drive, Louisville, Jefferson County, Kentucky, 40209, United States
LOUISVILLE, MS 393396318
Phone: (662) 773-7500
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 60 Open Payments records for all available years, with a total value of $1,072.
Total Amount is formed as General ($1,072) + Research ($0) + Ownership ($0) = $1,072.
Last reported payment date: 2024-12-09 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($293).
Total Amount
$1,072
General + Research + Ownership
Payments
60
Total payment records
General Amount
$1,072
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $293 |
| Novo Nordisk Inc | $292 |
| Lilly USA, LLC | $150 |
| Bayer Healthcare Pharmaceuticals Inc. | $94 |
| Abbott Laboratories | $86 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2009-12-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20091207000030 | I | Family Practice | MS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 39735)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MS | |
| Family Practice, Emergency Medicine | MS | |
| Emergency Medicine | MS | |
| - | MS | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS | |
| Emergency Medicine | MS | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS |
Reviews
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