Brent Anthony Sunderland, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

200201631 Issued in NC

Practice address

612 Mocksville Avenue
Charlotte, NC 28144-2732

Phone

(704) 210-5061

Fax

(704) 210-5337

NPI assigned

Feb 2, 2006

Last updated

Oct 20, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1487626750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-210-5061",
            "fax_number": "704-210-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 MOCKSVILLE AVENUE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "281442732",
            "telephone_number": "704-210-5061",
            "fax_number": "704-210-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERLAND",
        "first_name": "BRENT",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200201631",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "200201631",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89133CA",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01632",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naresh Sundaresan, MD
• Raghavanand Sundaresh
• Sunday Money, LLC (Home Instead)
• Thomas C Sundberg, M.D.
• Alicja Erazo Sundblade, FNP-C
• Theresa Kay Sunderland, MD
• Sunflower Speech & Myo Therapy, PLLC
• Sunflower Therapeutic Solutions, PLLC
• Maxim Sungurov
• Samhita Sunkara

• Psychiatry Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.