Donald J Sudy, MD

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

200201009 Issued in NC

Practice address

5821 Fairview Rd Ste 115
Charlotte, NC 28209-3649

Phone

(704) 643-2205

NPI assigned

Nov 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Central Kentucky Emergency Services P.S.C.

  • Emergency Medicine Physician
  • Shelbyville, KY
  • NPI 1497750194
  NPD (past)

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1174705396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5821 FAIRVIEW RD STE 115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093649",
            "telephone_number": "704-643-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 FAIRVIEW RD STE 115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093649",
            "telephone_number": "704-643-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDY",
        "first_name": "DONALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200201009",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "NC",
            "license": "200201009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89131YC",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7019449",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer E. Suckow, PA-C
• Tracy Suddreth, ACCNS-AG
• Sudha M Edpuganti DDS PLLC
• Kathryn Jane Sudikoff, DMD
• Justin Craig Sudlow, DPT
• Sue'S Mobile Services
• Luisa Suess, MA, QMHP,QRP
• Sugar Creek Medical Center, PLLC
• Sugarcreek Medical Center
• Gary R Sugg, DDS MS

• Phlebology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Phlebology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.