Robert W Surratt, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25087 Issued in NC

Practice address

1085 NE Gateway CT
Suite 200, Ardsley Internal Medicine
Concord, NC 28025-2406

Phone

(704) 260-8650

Fax

(704) 260-8665

NPI assigned

Feb 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Charlotte-Mecklenburg Hospital Authority

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  Internal Medicine, NC

  Medicare reassignment NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Endocrinology, Diabetes & Metabolism Physician
  • Huntersville, NC
  • NPI 1801223482
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1700858776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 NE GATEWAY CT",
            "address_2": "SUITE 200, ARDSLEY INTERNAL MEDICINE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252406",
            "telephone_number": "704-260-8650",
            "fax_number": "704-260-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 NE GATEWAY CT",
            "address_2": "SUITE 200, ARDSLEY INTERNAL MEDICINE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252406",
            "telephone_number": "704-260-8650",
            "fax_number": "704-260-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURRATT",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "25087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "31489",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID",
            "identifier": "4324723",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLPATH",
            "identifier": "111011",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "81014",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "298677",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID",
            "identifier": "110220835",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-OTHER",
            "identifier": "232009",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE TAX ID",
            "identifier": "566000156",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CH",
            "identifier": "5246",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8981014",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Elizabeth Sung, PA
• Sunnyview Home Care Staffing Agency LLC
• Support Incorporated
• Jessica Marie Surane, PA
• Alexis Brianna Lowe Surratt, LCMHC, LCASA
• Kinjal Suthar
• Monique Sutton, NP
• Leslie Eugene Swafford Jr., PA
• Erica Swanson
• Sharon Marie Swartz, PA-C

• Internal Medicine Physician in Concord, NC
• Providers in Concord, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.