Suzanne Stark, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN066998 Issued in GA

Practice address

510 Alston St Ste a
Richland, GA 31825-6012

Phone

(229) 887-3324

Fax

(229) 887-2559

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Careconnect Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Richland, GA
  • NPI 1063436624
  Medicare reassignment NPD
• Careconnect Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sylvester, GA
  • NPI 1811874696
  NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1053406199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 ALSTON ST STE A",
            "city": "RICHLAND",
            "state": "GA",
            "postal_code": "318256012",
            "telephone_number": "229-887-3324",
            "fax_number": "229-887-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 ALSTON ST STE A",
            "city": "RICHLAND",
            "state": "GA",
            "postal_code": "318256012",
            "telephone_number": "229-887-3324",
            "fax_number": "229-887-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN066998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alluri Raju, M.D.
• Richland Adult Day Center, LLC
• Carlos Cortez Seay
• Leslie Smith, NP-BC
• Rebecca Smith, FNP
• Stewart - Webster Hospital, Inc
• Stewart - Webster Hospital, Inc.
• Kinsey Brooke Stovall, NP
• Kimberly Powell Thomas
• U Save It Pharmacy Inc

• Family Nurse Practitioner in Richland, GA
• Providers in Richland, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.