NPIMap

Individual provider Active NPI

Slade Alan Suchecki, D.O.

  • Family Medicine Physician
  • Southport, NC
National Provider Identifier
1194839647
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200401133 Issued in NC
Practice address
3960 Executive Park Blvd
Suite 600
Southport, NC 28461-8184
Phone
(910) 454-4343
Fax
(910) 457-9209
NPI assigned
Aug 19, 2006
Last updated
Feb 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200401133 NC Primary

Addresses

Primary practice location

3960 Executive Park Blvd
Suite 600
Southport, NC 28461-8184

Mailing address

3960 Executive Park Blvd
Suite 600
Southport, NC 28461-8184
Phone (910) 454-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20070309000112 NC Practitioner - Family Practice 2264535426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3960 Executive Park Blvd
Suite 600
Southport, NC 28461-8185
Phone (910) 454-4343

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brunswick Family Medicine PA Family Medicine CurrentSince Apr 5, 2006 Accepting new patients

Locations

3960 Executive Park Blvd
Ste 600
Southport, NC 28461
Phone (910) 454-4343

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11802/brand/1/csg/1/fhir/r4
  • Direct secure messaging: slade.suchecki.1@11802.direct.athenahealth.com

Organizations & group practices 1

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 7

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265587200000",
    "number": "1194839647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 EXECUTIVE PARK BLVD",
            "address_2": "SUITE 600",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618184",
            "telephone_number": "910-454-4343",
            "fax_number": "910-457-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 EXECUTIVE PARK BLVD",
            "address_2": "SUITE 600",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618184",
            "telephone_number": "910-454-4343",
            "fax_number": "910-457-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCHECKI",
        "first_name": "SLADE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2010-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200401133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

Verify at the official NPI Registry.