NPIMap

Individual provider Active NPI

Sonia Suda

  • Internal Medicine Physician
  • Greensboro, GA
National Provider Identifier
1104210459
Registry record updated Oct 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
079960 Issued in GA
Practice address
803 S Main St
Greensboro, GA 30642-1211
Phone
(706) 453-1201
NPI assigned
Mar 25, 2015
Last updated
Oct 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 079960 GA Primary

Addresses

Primary practice location

803 S Main St
Greensboro, GA 30642-1211

Mailing address

803 S Main St
Greensboro, GA 30642-1211
Phone (706) 453-1201

Other practice location 1

1500 Oglethorpe Ave
Athens, GA 30606-2179
Phone (706) 389-3975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190910002473 SC Practitioner - Hospitalist 3678878808 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Tulane University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians of SC LLCGroup PAC ID 5890127344, 136 clinicians

Practice addresses (Care Compare)

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1006

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2901

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
79.17
Improvement activities
40
Cost
69.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians of SC, LLC Multi-Specialty CurrentSince Dec 15, 2020 Accepting new patients
Georgetown Memorial Hospital CurrentSince Aug 5, 2019 Accepting new patients
Waccamaw Community Hospital Multi-Specialty CurrentSince Aug 5, 2019 Accepting new patients
Georgetown Memorial Hospital Multi-Specialty CurrentSince Aug 5, 2019 Accepting new patients

Locations

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

4070 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-5100

Organizations & group practices 4

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540684800000",
    "number": "1104210459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 S MAIN ST",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306421211",
            "telephone_number": "706-453-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 S MAIN ST",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306421211",
            "telephone_number": "706-453-1201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Oglethorpe Ave",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062179",
            "country_code": "US",
            "telephone_number": "706-389-3975",
            "fax_number": "706-389-3876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUDA",
        "first_name": "SONIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2018-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "079960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, GA

Sources for this page

Verify at the official NPI Registry.