NPIMap

Organization Active NPI

Sumter Medical Specialists PA

  • Nephrology Physician
  • Sumter, SC
National Provider Identifier
1619069481
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
08460 Issued in SC
Legal business name
SUMTER MEDICAL SPECIALISTS PA
Practice address
635 W Wesmark Blvd
Sumter, SC 29150-1900
Phone
(803) 469-7500
Fax
(803) 469-7521
NPI assigned
Sep 29, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Pusadee Suchinda, MDNPI 1194817932
Title
Owner, Sec/Treas
Phone
(803) 469-7500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 20072 SC
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 10500 SC
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 23697 SC
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 10273 SC
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 08460 SC Primary

Addresses

Primary practice location

635 W Wesmark Blvd
Sumter, SC 29150-1900

Mailing address

635 W Wesmark Blvd
Sumter, SC 29150-1900
Phone (803) 469-7500

Other identifiers 2

IdentifierTypeStateIssuer
DPE034OtherSCMEDICAID DM EDUC PROGRAM
PA7750MedicaidSC

Other names 1

  • CAROLINA DIABETES & KIDNEY CENTER Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325000405 SC Part B Supplier - Clinic/Group Practice 2264324433 Receives reassigned benefits from 4 practitioners
Practice locations: Sumter, SC

National Provider Directory

National Provider Directory

Locations

3618 J Dewey Gray Cir
Augusta, GA 30909
Phone (706) 520-7442

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEAHAD

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1619069481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501900",
            "telephone_number": "803-469-7500",
            "fax_number": "803-469-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501900",
            "telephone_number": "803-469-7500",
            "fax_number": "803-469-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMTER MEDICAL SPECIALISTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SUCHINDA",
        "authorized_official_first_name": "PUSADEE",
        "authorized_official_title_or_position": "OWNER, SEC/TREAS",
        "authorized_official_telephone_number": "803-469-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "20072",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "10500",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "23697",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "10273",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "08460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DM EDUC PROGRAM",
            "identifier": "DPE034",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA7750",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAROLINA DIABETES & KIDNEY CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.