Individual provider Active NPI

Suzanne Marlene Oellerich, PA-C

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1043172430
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13550 Issued in GA
Practice address
1580 Walton Way
Augusta, GA 30904-3763
Phone
(706) 434-1590
NPI assigned
Nov 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13550 GA Primary

Addresses

Primary practice location

1580 Walton Way
Augusta, GA 30904-3763

Mailing address

1580 Walton Way
Augusta, GA 30904-3763
Phone (706) 434-1590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260223002324 GA Practitioner - Physician Assistant 1254812720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 780
Thomson, GA 30824

PO Box
Suite 780
Thomson, GA 30824-0780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13550GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Improvement Project, Inc CurrentSince Dec 22, 2025 Accepting new patients
Neighborhood Improvement Project Inc CurrentSince Dec 22, 2025 Accepting new patients

Locations

1580 Walton Way
Augusta, GA 30904
Phone (706) 434-1590

2467 Golden Camp Rd
Augusta, GA 30906
Phone (706) 922-0682

2050 Walton Way
Ste 101
Augusta, GA 30904
Phone (706) 434-1590

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1043172430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309043763",
            "telephone_number": "706-434-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309043763",
            "telephone_number": "706-434-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OELLERICH",
        "first_name": "SUZANNE",
        "middle_name": "MARLENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-24",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.