Active NPI
Susan Bullard Staton, P.T.
- Pediatric Physical Therapist
- Scotland Neck, NC
National Provider Identifier
1477504983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 6171
- Practice address
- 728 Accree Edmundson Rd
Scotland Neck, NC 27874-8564 - Phone
- (252) 826-2099
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 6171 | NC | Primary |
Addresses
Primary practice location
728 Accree Edmundson Rd
Scotland Neck, NC 27874-8564
Mailing address
728 Accree Edmundson Rd
Scotland Neck, NC 27874-8564
Phone (252) 826-2099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6171 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1477504983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "728 ACCREE EDMUNDSON RD",
"city": "SCOTLAND NECK",
"state": "NC",
"postal_code": "278748564",
"telephone_number": "252-826-2099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "728 ACCREE EDMUNDSON RD",
"city": "SCOTLAND NECK",
"state": "NC",
"postal_code": "278748564",
"telephone_number": "252-826-2099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STATON",
"first_name": "SUSAN",
"middle_name": "BULLARD",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NC",
"license": "6171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scotland Neck, NC
- Rural Carolina Ambulance Service, LLC
- Rural Health Group, Inc. (Rural Health Group at Scotland Neck)
- Scotland Neck Family Medical Center, Inc.
- Scotland Neck NC Opco LLC (Scotland Manor Health and Rehabilitation Center)
- Christopher A Smith, PHARM.D
- Wandalyn Isaac Teague, LPC/NCC
- United Medical Supplies Inc
- United Services Group Inc
- Latara Wade, PTA
- Wescare Professional Services, LLC.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.