Individual provider Active NPI

Theodore Franklin Suggs, M.D.

  • Family Medicine Physician
  • Harrisburg, NC
National Provider Identifier
1215952585
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27405 Issued in NC
Practice address
12170 University City Blvd
Harrisburg, NC 28075-7406
Phone
(704) 863-6790
Fax
(704) 863-6953
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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 27405 NC Primary

Addresses

Primary practice location

12170 University City Blvd
Harrisburg, NC 28075-7406

Mailing address

PO Box 601067
Charlotte, NC 28260-1067
Phone (704) 863-6970

Other identifiers 1

IdentifierTypeStateIssuer
8980782MedicaidNC

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27405NCMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1215952585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601067",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601067",
            "telephone_number": "704-863-6970",
            "fax_number": "704-863-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12170 UNIVERSITY CITY BLVD",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757406",
            "telephone_number": "704-863-6790",
            "fax_number": "704-863-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGGS",
        "first_name": "THEODORE",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "27405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8980782",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.