NPIMap

Individual provider Active NPI

Jennifer E. Suckow, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1891779245
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05692 Issued in NC
Practice address
2001 Vail Ave
Suite 200
Charlotte, NC 28207-1248
Phone
(704) 323-2000
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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 0010-05692 NC Primary

Addresses

Primary practice location

2001 Vail Ave
Suite 200
Charlotte, NC 28207-1248

Mailing address

4601 Park Rd
Suite 300
Charlotte, NC 28209-3239
Phone (704) 323-2000

Other names 1

  • Jennifer E. Borger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160120002057 NC Practitioner - Physician Assistant 6800857152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

101 Delta Park Dr
Shelby, NC 28150-3575
Phone (704) 484-0606

1915 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 323-2282

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

5935 Carnegie Blvd
Suite 104
Charlotte, NC 28209-4672
Phone (704) 323-2500

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina, PA Physician Assistant CurrentSince Oct 31, 2015 Accepting new patients
Orthocarolina Physician Assistant CurrentSince Oct 31, 2015 Accepting new patients
Triad Radiology Associates PLLC Past Accepting new patients
Orthocarolina Physician Assistant Past Accepting new patients
Midwest Orthopaedics at Rush, LLC Past Accepting new patients

Locations

5935 Carnegie Blvd
Ste 200
Charlotte, NC 28209

2001 Vail Ave
Ste 200
Charlotte, NC 28207
Phone (704) 323-2564

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

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 and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1891779245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093239",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 VAIL AVE",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071248",
            "telephone_number": "704-323-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCKOW",
        "first_name": "JENNIFER",
        "middle_name": "E.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BORGER",
            "middle_name": "E.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.