Brunswick Family Medicine PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BRUNSWICK FAMILY MEDICINE PA

Practice address

3960 Executive Park Blvd
Unit 600
Southport, NC 28461

Phone

(910) 454-4343

Fax

(910) 457-9209

NPI assigned

Aug 19, 2006

Last updated

Sep 25, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Slade Alan Suchecki, D.O.NPI 1194839647

Title

President

Phone

(910) 454-4343

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11802/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Slade Alan Suchecki, D.O.

  • Family Medicine Physician
  • Southport, NC
  • NPI 1194839647
  Medicare reassignment NPD Authorized official
• Sherrie Gray Cass, FNP-C

  • Family Nurse Practitioner
  • Southport, NC
  • NPI 1649736653
  Medicare reassignment NPD
• Rick J Hernandez, M.D.

  • Family Medicine Physician
  • Southport, NC
  • NPI 1437351806
  Medicare reassignment NPD

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1396859872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 EXECUTIVE PARK BLVD",
            "address_2": "UNIT 600",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "28461",
            "telephone_number": "910-454-4343",
            "fax_number": "910-457-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 EXECUTIVE PARK BLVD",
            "address_2": "UNIT 600",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "28461",
            "telephone_number": "910-454-4343",
            "fax_number": "910-457-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUNSWICK FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "SUCHECKI",
        "authorized_official_first_name": "SLADE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-454-4343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Renee Bridges, LMBT, RN
• Kymber Broadhead
• Irene R. Brook, LCSW
• Aaron Lee Brown, D.O.
• Kayde Renee Brown, DPT
• Brunswick Holistic Therapy Inc
• Kurtis Bryan, DMD
• John A'Hearn Burdette, MD
• Carolina Anna Candelaria, MSPT
• Lauren Cannon Durham, CNP

• Family Medicine Physician in Southport, NC
• Providers in Southport, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.