Individual provider Active NPI

Surinia Stocks Thurman, IBCLC, LMBT

  • Independent Duty Medical Technicians
  • Davidson, NC
National Provider Identifier
1295979078
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty Medical TechniciansTaxonomy code 1710I1003X
Practice address
522 Potts St
Davidson, NC 28036-8406
Phone
(704) 997-9406
Fax
(704) 896-4907
NPI assigned
Apr 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Medical Technicians 1710I1003X Primary

Addresses

Primary practice location

522 Potts St
Davidson, NC 28036-8406

Mailing address

522 Potts St
Davidson, NC 28036-8406
Phone (704) 997-9406

Other practice location 1

77 Nealy Avenue
1st Medical Group
Langley AFB, VA 23665-2040
Phone (757) 225-7630

Other identifiers 2

IdentifierTypeStateIssuer
20159OtherNCLMBT
L-307326OtherNCIBCLC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Surinia@lknbreastfeedingsolutions.com

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Norman Breastfeeding Solutions LLC CurrentSince Jul 17, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1295979078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 POTTS ST",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368406",
            "telephone_number": "704-997-9406",
            "fax_number": "704-896-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 POTTS ST",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368406",
            "telephone_number": "704-997-9406",
            "fax_number": "704-896-4907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Nealy Avenue",
            "address_2": "1st Medical Group",
            "address_purpose": "LOCATION",
            "city": "Langley AFB",
            "state": "VA",
            "postal_code": "236652040",
            "country_code": "US",
            "telephone_number": "757-225-7630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THURMAN",
        "first_name": "SURINIA",
        "middle_name": "STOCKS",
        "credential": "IBCLC, LMBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2025-09-11",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMBT",
            "identifier": "20159",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBCLC",
            "identifier": "L-307326",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Surinia@lknbreastfeedingsolutions.com",
            "affiliation": "N",
            "address_1": "522 Potts St",
            "city": "Davidson",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280368406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.