NPIMap

Organization Active NPI

Mary Sue Suggs

Doing business as Main Street Medical Clinic

  • Family Medicine Physician
  • Pell City, AL
National Provider Identifier
1447246053
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARY SUE SUGGS
Doing business as
Main Street Medical Clinic
Practice address
1508 Cogswell Ave
Pell City, AL 35125-1243
Phone
(205) 814-1598
Fax
(205) 814-1587
NPI assigned
Sep 20, 2005
Last updated
Jan 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Authorized official

Name
Mary Sue Suggs, CRNPNPI 1154317758
Title
Owner
Phone
(205) 814-1598

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1508 Cogswell Ave
Pell City, AL 35125-1243

Mailing address

1508 Cogswell Ave
Pell City, AL 35125-1243
Phone (205) 814-1598

Other identifiers 1

IdentifierTypeStateIssuer
541003917MedicaidAL

Other names 1

  • MAIN STREET MEDICAL CLINIC Doing business as

National Provider Directory

National Provider Directory

Locations

1508 Cogswell Ave
Pell City, AL 35125
Phone (205) 814-1598

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264636800000",
    "number": "1447246053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 COGSWELL AVE",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351251243",
            "telephone_number": "205-814-1598",
            "fax_number": "205-814-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 COGSWELL AVE",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351251243",
            "telephone_number": "205-814-1598",
            "fax_number": "205-814-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY SUE SUGGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2010-01-28",
        "status": "A",
        "authorized_official_last_name": "SUGGS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-814-1598",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "541003917",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAIN STREET MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pell City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.