Organization Active NPI

Suzanne M. Everhart, D.O., P.C.

  • Ophthalmology Physician
  • Ashland, VA
National Provider Identifier
1033445713
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101037079 Issued in VA
Legal business name
SUZANNE M. EVERHART, D.O., P.C.
Practice address
204 Virginia St
Ashland, VA 23005-2049
Phone
(804) 752-7508
Fax
(804) 798-6876
NPI assigned
Oct 30, 2009
Last updated
Oct 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Suzanne M Everhart, D.O.NPI 1518076181
Title
President
Phone
(804) 752-7508

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101037079 VA Primary

Addresses

Primary practice location

204 Virginia St
Ashland, VA 23005-2049

Mailing address

204 Virginia St
Ashland, VA 23005-2049
Phone (804) 752-7508

Other identifiers 1

IdentifierTypeStateIssuer
6301495MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100316000095 VA Part B Supplier - Clinic/Group Practice 8729113873 Receives reassigned benefits from 1 practitioner
Practice locations: Ashland, VA

National Provider Directory

National Provider Directory

Locations

204 Virginia St
Ashland, VA 23005
Phone (804) 752-7508

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256860800000",
    "number": "1033445713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 VIRGINIA ST",
            "city": "ASHLAND",
            "state": "VA",
            "postal_code": "230052049",
            "telephone_number": "804-752-7508",
            "fax_number": "804-798-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 VIRGINIA ST",
            "city": "ASHLAND",
            "state": "VA",
            "postal_code": "230052049",
            "telephone_number": "804-752-7508",
            "fax_number": "804-798-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUZANNE M. EVERHART, D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2009-10-30",
        "status": "A",
        "authorized_official_last_name": "EVERHART",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-752-7508",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101037079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6301495",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.