Carlos Surratt

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Practice address

122 E Dixon Blvd
Shelby, NC 28152-6742

Phone

(803) 849-2925

NPI assigned

Dec 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Express Transportation Services

  • Non-emergency Medical Transport (VAN)
  • Shelby, NC
  • NPI 1467112805
  NPD Authorized official

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1043970312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E DIXON BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526742",
            "telephone_number": "803-849-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E DIXON BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526742",
            "telephone_number": "803-849-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURRATT",
        "first_name": "CARLOS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-28",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Huber Sullivan, MS, LPC
• Support Incorporated
• Support Incorporated
• Vamsi Surapaneni, PHARMD
• Sure Care, LLC
• Survivor Friendly LLC (Survivor Friendly Manelines)
• Survivor Friendly, LLC (Manelines Unique Boutique)
• Amber Nicole Swanner, RD
• Sweet Caroline Assisted Living LLC
• Anita Jean Szabo, LCSW

• Non-emergency Medical Transport (VAN) in Shelby, NC
• Providers in Shelby, NC by specialty
• Non-emergency Medical Transport (VAN) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.