Susie Fitzgerald, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2021-00367 Issued in NC

Practice address

607 Beaman St
Clinton, NC 28328-2603

Phone

(910) 596-5421

Fax

(910) 596-5432

NPI assigned

Mar 29, 2006

Last updated

Jun 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Family PracticeAlso: Hospitalist

Education

Campbell Univ School of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sampson Regional Professional Services LLCGroup PAC ID 6406992817, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sampson Regional Medical Center Hospital, Clinton, NC, CCN 340024
• Betsy Johnson Regional Hospital Hospital, Dunn, NC, CCN 340071

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sampson Regional Professional Services LLC

  dba Sampson Family Medicine

  • Family Medicine Physician
  • Clinton, NC
  • NPI 1730311648
  Medicare reassignment Care Compare group NPD
• Sampson Regional Hospitalists, LLC

  • Hospitalist Physician
  • Clinton, NC
  • NPI 1902126444

  Family Medicine

  Medicare reassignment NPD
• Sampson Regional Professional Services, LLC

  dba Sampson Surgical Services

  • Surgery Physician
  • Clinton, NC
  • NPI 1760744361
  NPD
• Sampson Regional Medical Center

  • General Acute Care Hospital
  • Clinton, NC
  • NPI 1609857432
  NPD (past)

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

• Harnett Health System, Inc.

  dba Cape Fear Valley Betsy Johnson Hospital and Cape Fear Valley Central Harnett Hospital

  • General Acute Care Hospital
  • Dunn, NC
  • NPI 1922144757
  Care Compare affiliation
• Sampson Regional Medical Center

  • General Acute Care Hospital
  • Clinton, NC
  • NPI 1609857432
  Care Compare affiliation

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1902867179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283290260",
            "telephone_number": "910-596-5421",
            "fax_number": "910-596-5432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 BEAMAN ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282603",
            "telephone_number": "910-596-5421",
            "fax_number": "910-596-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "SUSIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-00367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412455",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBCBS",
            "identifier": "141J6",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susie-fitzgerald@sampsonrps.e-mdsdirect.com",
            "affiliation": "Y",
            "endpointDescription": "Sampson Medical Group Direct Address",
            "affiliationName": "Sampson Regional Professional Services LLC.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "516 Beaman St",
            "city": "Clinton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283282602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Ashley Ezzell, LAC
• Pamelia Elaine Faison-Davis
• Family First Support Center Inc
• Family Medical Supply LLC
• Joshua Ferrell, M.D.
• Andres R Fleury-Guzman, MD
• FLR Counseling LLC
• Forest Trail of Clinton, LLC (The Magnolia)
• Fuller & Associates VII PLLC
• Rashida Asha Fuller, LCSW-A

• Family Medicine Physician in Clinton, NC
• Providers in Clinton, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.