Individual provider Active NPI

Susan Sobczak, RN

  • General Practice Registered Nurse
  • Mount Pleasant, SC
National Provider Identifier
1538870993
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
259373R Issued in SC
Practice address
2815 Wagner Way
Mount Pleasant, SC 29466-7218
Phone
(571) 427-5995
NPI assigned
Dec 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 259373R SC Primary

Addresses

Primary practice location

2815 Wagner Way
Mount Pleasant, SC 29466-7218

Mailing address

2815 Wagner Way
Mount Pleasant, SC 29466-7218
Phone (571) 427-5995

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
259373RSCMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1538870993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 WAGNER WAY",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294667218",
            "telephone_number": "571-427-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 WAGNER WAY",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294667218",
            "telephone_number": "571-427-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBCZAK",
        "first_name": "SUSAN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "SC",
            "license": "259373R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.