Individual provider Active NPI

Mark D. Suarez, PA-C

  • Physician Assistant
  • Glenville, WV
National Provider Identifier
1578513115
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
869 Issued in WV
Practice address
809 Mineral Rd
Glenville, WV 26351-1385
Phone
(304) 462-7322
Fax
(304) 462-4052
NPI assigned
May 12, 2006
Last updated
Dec 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 869 WV Primary

Addresses

Primary practice location

809 Mineral Rd
Glenville, WV 26351-1385

Mailing address

809 Mineral Rd
Glenville, WV 26351-1385
Phone (304) 462-7322

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
869WVMDClinical Psychologist
1120SCMDRegistered Dietitian
233WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bestpractices of North Carolina, Inc. Past Accepting new patients
Clyde Emergency Solutions LLC Past Accepting new patients
Elm Emergency Group PLLC Past Accepting new patients
West Virginia Em-I Medical Services Physician Assistant Past Accepting new patients
South Carolina Em-I Medical Services PC Physician Assistant Past Accepting new patients
Bestpractices of North Carolina PC Past Accepting new patients
Bestpractices of Pennsylvania PC Past Accepting new patients

Organizations & group practices 7

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.

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": "1291334400000",
    "number": "1578513115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 MINERAL RD",
            "city": "GLENVILLE",
            "state": "WV",
            "postal_code": "263511385",
            "telephone_number": "304-462-7322",
            "fax_number": "304-462-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 MINERAL RD",
            "city": "GLENVILLE",
            "state": "WV",
            "postal_code": "263511385",
            "telephone_number": "304-462-7322",
            "fax_number": "304-462-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "MARK",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.