Individual provider Active NPI

Suzanne K Hentz, MD

  • Gynecology Physician
  • Wilmington, NC
National Provider Identifier
1407892359
Registry record updated Sep 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
29589 Issued in NC
Practice address
4815 Oleander Dr
Suite 202
Wilmington, NC 28403-5108
Phone
(910) 452-1133
Fax
(910) 452-5829
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 29589 NC Primary

Addresses

Primary practice location

4815 Oleander Dr
Suite 202
Wilmington, NC 28403-5108

Mailing address

4815 Oleander Dr
Suite 202
Wilmington, NC 28403-5108
Phone (910) 452-1133

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220518001687 NC Practitioner - Obstetrics/Gynecology 0143607804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29589NCMDPharmacist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222041600000",
    "number": "1407892359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 OLEANDER DR",
            "address_2": "SUITE 202",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035108",
            "telephone_number": "910-452-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 OLEANDER DR",
            "address_2": "SUITE 202",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035108",
            "telephone_number": "910-452-1133",
            "fax_number": "910-452-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTZ",
        "first_name": "SUZANNE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NC",
            "license": "29589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.