Susan Evans Gore, AU.D.
Individual provider Active NPI Audiologist-Hearing Aid Fitter · Supply, NC
NPI 1801803192 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1801803192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist-Hearing Aid Fitter 237600000X
- License
- 1102 (NC)
- Practice address
- 2298 Ocean Hwy W
Supply, NC 28462-4024 - Phone
- (910) 755-2428
- Fax
- (910) 755-2435
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1075 | SC | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Hearing Centers, Inc | Past | Accepting new patients | |
| Providence Anesthesiology Associates, P.a. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1102 | NC | |
| Audiologist-Hearing Aid Fitter | 237600000X | 1102 | NC | Yes |
Addresses
Primary practice location
2298 Ocean Hwy W
Supply, NC 28462-4024
Mailing address
PO Box 4868
Calabash, NC 28467-9820
Phone (910) 755-2428
Other practice location 1
302 Liberty St
Whiteville, NC 28472-3714
Phone (910) 642-3675
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3404235 | Medicaid | NC |
Other providers in Supply, NC
- William Stewart Futch Jr.
- Galloway Sands LLC
- Galloway Sands, LLC
- Joseph Richmond Galloway Jr.
- Susan Dennie Gibble
- Charles Daniel Hall
- Gina M. Hamilton
- Sabrina Elizabeth Harkey
- Carla Harper-Martinez
- Ryan Austin Harrell
All providers in Supply, NC · Audiologist-Hearing Aid Fitter in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.