Mary Sue Suggs

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1052565 Issued in AL

Practice address

1508 Cogswell Ave
Pell City, AL 35125-1243

Phone

(205) 814-1598

Fax

(205) 814-1587

NPI assigned

Sep 20, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Mary Sue Suggs

  dba Main Street Medical Clinic

  • Family Medicine Physician
  • Pell City, AL
  • NPI 1447246053
  NPD Authorized official

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1154317758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 COGSWELL AVE",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351251243",
            "telephone_number": "205-814-1598",
            "fax_number": "205-814-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 COGSWELL AVE",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351251243",
            "telephone_number": "205-814-1598",
            "fax_number": "205-814-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGGS",
        "first_name": "MARY",
        "middle_name": "SUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "1052565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891001850",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "051550183",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chelsea Taylor

• Family Medicine Physician in Pell City, AL
• Providers in Pell City, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.