Susie Thomas
Individual provider Active NPI Bus · Henderson, NC
NPI 1306379474 · NPPES record last updated Apr 6, 2017
Key facts
- NPI
- 1306379474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Bus 347B00000X
- License
- 81-2857034 (NC)
- Practice address
- 1001 Health Center Rd
Henderson, NC 27536-5482 - Phone
- (252) 204-9866
- NPI assigned
- Apr 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81-2857034 | NC | MD | Bus |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Bus | 347B00000X | 81-2857034 | NC | Yes |
Addresses
Primary practice location
1001 Health Center Rd
Henderson, NC 27536-5482
Mailing address
PO Box 1164
Henderson, NC 27536-1164
Phone (252) 204-9866
Other providers in Henderson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.