Individual provider Active NPI

Kristy Marie Su, FNP

  • Family Nurse Practitioner
  • Cary, NC
National Provider Identifier
1134435449
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5004851 Issued in NC
Practice address
106 Ridge View Dr Ste a
Cary, NC 27511-6647
Phone
(919) 319-6363
Fax
(919) 319-1331
NPI assigned
Aug 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5004851 NC Primary

Addresses

Primary practice location

106 Ridge View Dr Ste a
Cary, NC 27511-6647

Mailing address

106 Ridge View Dr Ste a
Cary, NC 27511-6647
Phone (919) 319-6363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20120417000662 NC Practitioner - Nurse Practitioner 9234390329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians
Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

1129 Weaver Dairy Rd
Suite N
Chapel Hill, NC 27514-1960
Phone (919) 968-5959

98 Chapelton CT
Suite 310
Chapel Hill, NC 27516-8487
Phone (919) 590-9005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5004851NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Feb 1, 2019 Accepting new patients
Breakthrough Physical Therapy Inc PastSince Feb 1, 2019 Accepting new patients

Locations

98 Chapelton Ct
#310
Chapel Hill, NC 27516
Phone (918) 240-4799

1821 Martin Luther King Pkwy
Durham, NC 27707
Phone (919) 748-4980

7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880

10900 World Trade Blvd
Ste A
Raleigh, NC 27617

Interoperability endpoints

  • Direct secure messaging: ksu34901@fastmed.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1134435449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 RIDGE VIEW DR STE A",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116647",
            "telephone_number": "919-319-6363",
            "fax_number": "919-319-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 RIDGE VIEW DR STE A",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116647",
            "telephone_number": "919-319-6363",
            "fax_number": "919-319-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "KRISTY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.