Active NPI
Mark Stephen Sudekum, LCSW
- Clinical Social Worker
- Greenville, NC
National Provider Identifier
1497077861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C007438
- Practice address
- 2602 Courtier Dr
Greenville, NC 27834-7818 - Phone
- (252) 752-0483
- Fax
- (252) 757-3172
- NPI assigned
- Feb 25, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1578 | NC | |
| Clinical Social Worker | 1041C0700X | C007438 | NC | Primary |
Addresses
Primary practice location
2602 Courtier Dr
Greenville, NC 27834-7818
Mailing address
4300 Sapphire CT Ste 110
Greenville, NC 27834-9079
Phone (252) 830-7561
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Brody School of Medicine at East Carolina University, 2009
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
101 Cabarrus Ave E
Suite 200
Concord, NC 28025-3781
Phone (855) 743-2247
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1578 | NC | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eventus Wholehealth, PLLC | Clinical | Current | Accepting new patients |
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757808000000",
"number": "1497077861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 SAPPHIRE CT STE 110",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278349079",
"telephone_number": "252-830-7561",
"fax_number": "252-413-0932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2602 COURTIER DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278347818",
"telephone_number": "252-752-0483",
"fax_number": "252-757-3172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUDEKUM",
"first_name": "MARK",
"middle_name": "STEPHEN",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-25",
"last_updated": "2025-09-14",
"certification_date": "2025-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "1578",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C007438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.