Individual provider Active NPI

Stephanie Sussman, M.D.

  • Pediatrics Physician
  • Chapel Hill, NC
National Provider Identifier
1679887905
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2016-00592 Issued in NC
Practice address
1181 Weaver Dairy Rd Ste 210
Chapel Hill, NC 27514-1870
Phone
(984) 215-4339
Fax
(984) 215-4342
NPI assigned
Jul 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2016-00592 NC Primary

Addresses

Primary practice location

1181 Weaver Dairy Rd Ste 210
Chapel Hill, NC 27514-1870

Mailing address

54 Horizon Dr
Pittsboro, NC 27312-5797
Phone (412) 926-2172

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssussman174959@direct.UNC.nchie.net Direct

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160531000804 NC Practitioner - Pediatric Medicine 1658540927 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2016-00592NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Pediatrics CurrentSince Apr 15, 2016 Accepting new patients
Unc Physicians Network LLC Pediatrics CurrentSince Apr 15, 2016 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

1181 Weaver Dairy Rd
Ste 210
Chapel Hill, NC 27514
Phone (984) 215-4339

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

Interoperability endpoints

  • Direct secure messaging: ssussman174959@direct.unc.nchie.net

Organizations & group practices 3

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": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1679887905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HORIZON DR",
            "city": "PITTSBORO",
            "state": "NC",
            "postal_code": "273125797",
            "telephone_number": "412-926-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 WEAVER DAIRY RD STE 210",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275141870",
            "telephone_number": "984-215-4339",
            "fax_number": "984-215-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "STEPHANIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-28",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2016-00592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssussman174959@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1181 Weaver Dairy Rd Ste 210",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275141870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.