Shuborna Bonnie Nath Suwan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

90723 Issued in SC

Practice address

300 E Hospital Rd
Fort Eisenhower, GA 30905-0000

Phone

(706) 787-5811

NPI assigned

Apr 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ssuwan312054@directhisp.wakemed.org

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.

• North Augusta Pediatrics LLC

  • Rural Health Clinic/Center
  • North Augusta, SC
  • NPI 1194496745
  NPD (past)
• North Augusta Pediatrics LLC

  • Pediatrics Physician
  • North Augusta, SC
  • NPI 1700068293
  NPD (past)

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1376163048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E HOSPITAL RD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "30905",
            "telephone_number": "706-787-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E HOSPITAL RD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "309050000",
            "telephone_number": "706-787-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUWAN",
        "first_name": "SHUBORNA",
        "middle_name": "BONNIE NATH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2025-09-11",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "90723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stevi Bagwell Shaw, PHARMD
• Dustin Kyle Smith Jr., DMD
• Melissa Jo Sparks, M.D.
• Stephen Spivey, MD
• Brianne Carmela Russ Sullivan, OTR/L
• Shima Shaikh Syed, M.D.
• Shanieca Taylor
• Tiffany Y Taylor, MD
• Alexandra Telly, PT
• Dafiney Thomas

• Pediatrics Physician in Fort Eisenhower, GA
• Providers in Fort Eisenhower, GA by specialty
• Pediatrics Physician in Georgia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.