Susan Brickle, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

031883 Issued in GA

Practice address

120 E Carter Ave
Blackshear, GA 31516-1561

Phone

(912) 449-4426

Fax

(912) 449-1059

NPI assigned

Jul 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385
  Medicare reassignment NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment NPD
• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124

  GA

  Medicare reassignment NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment
• Georgia Physician South,PC

  • Clinical Medical Laboratory
  • Blackshear, GA
  • NPI 1639381171
  Authorized official Same address or phone
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407876188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E CARTER AVE",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315161561",
            "telephone_number": "912-449-4426",
            "fax_number": "912-449-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E CARTER AVE",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315161561",
            "telephone_number": "912-449-4426",
            "fax_number": "912-449-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKLE",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "031883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00734467E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blackshear Family Dentistry LLC
• Bloom Well Health Clinic LLC
• Linton Dunbar Boatright
• James Dowling Bowen
• Pamela Michelle Bradley, FNP-C
• Cynthia L Brookshire, RN
• Dean Carl Broome, M.D,
• Kay Brown
• C and S Pharmacy Consultants
• Camellia Group Home

• Family Medicine Physician in Blackshear, GA
• Providers in Blackshear, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.