Active NPI
Gary Brian Sutherby Jr., PHARMD
- Pharmacist
- Thomasville, NC
National Provider Identifier
1104193184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16094
- Practice address
- 1122 Randolph St
Thomasville, NC 27360-5175 - Phone
- (336) 476-8190
- NPI assigned
- Nov 19, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16094 | NC | Primary |
Addresses
Primary practice location
1122 Randolph St
Thomasville, NC 27360-5175
Mailing address
1122 Randolph St
Thomasville, NC 27360
Phone (336) 476-8190
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0295872 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16094 | NC | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321660800000",
"number": "1104193184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 RANDOLPH ST",
"city": "THOMASVILLE",
"state": "NC",
"postal_code": "27360",
"telephone_number": "336-476-8190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1122 RANDOLPH ST",
"city": "THOMASVILLE",
"state": "NC",
"postal_code": "273605175",
"telephone_number": "336-476-8190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTHERBY",
"first_name": "GARY",
"middle_name": "BRIAN",
"name_suffix": "Jr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-19",
"last_updated": "2011-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "16094",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0295872",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thomasville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.