Individual provider Active NPI

Dana Kelli Suggs

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1205113149
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009221 Issued in NC
Practice address
4319 Chuck Hollow LN
Charlotte, NC 28277-3778
Phone
(049) 991-1317
NPI assigned
Nov 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C009221 NC Primary

Addresses

Primary practice location

4319 Chuck Hollow LN
Charlotte, NC 28277-3778

Mailing address

4319 Chuck Hollow LN
Charlotte, NC 28277-3778
Phone (704) 999-1131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C009221NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1205113149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 CHUCK HOLLOW LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773778",
            "telephone_number": "704-999-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 CHUCK HOLLOW LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773778",
            "telephone_number": "049-991-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGGS",
        "first_name": "DANA",
        "middle_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-07",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.