NPIMap

Individual provider Active NPI

Audrey Lynn Sutton-Surak, DO

  • Family Medicine Physician
  • Wilmington, NC
National Provider Identifier
1922080811
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200501955 Issued in NC
Practice address
1013 Porters Neck Rd
Suite 100
Wilmington, NC 28411
Phone
(910) 686-1099
Fax
(910) 686-4715
NPI assigned
Nov 16, 2005
Last updated
Aug 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB6325500 NJ
Family Medicine Physician 207Q00000X 200501955 NC Primary

Addresses

Primary practice location

1013 Porters Neck Rd
Suite 100
Wilmington, NC 28411

Mailing address

1013 Porters Neck Rd
Suite 100
Wilmington, NC 28411-8130
Phone (910) 686-1099

Other identifiers 4

IdentifierTypeStateIssuer
1378260OtherUNITED HEATHCARE
9614555OtherCIGNA
5231159OtherAETNA
5904062MedicaidNC

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
I20070609000020 NC Practitioner - Family PracticePractitioner - Hospice/Palliative Care 8224064969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospice/Palliative Care
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Systems, P.a.Group PAC ID 8527053024, 3 clinicians

Practice addresses (Care Compare)

1007 Porters Neck Rd
Wilmington, NC 28411-7383
Phone (910) 679-9885

1013 Porters Neck Rd
Suite 100
Wilmington, NC 28411-8131
Phone (910) 686-1099

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Phone (828) 456-7311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200501955NCMDFamily Medicine Physician
25MB6325500NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of North Carolina - Burlington, PC CurrentSince Jul 22, 2025 Accepting new patients
Senior Care Systems, P.a. Family Medicine CurrentSince Apr 1, 2010 Accepting new patients
Integrated Medicine Alliance PA Family Medicine PastSince Jan 1, 1998 Accepting new patients

Locations

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

1013 Porters Neck Rd
Ste 100
Wilmington, NC 28411
Phone (910) 319-2050

Interoperability endpoints

  • Direct secure messaging: asurak@healthpartnersnc.amazing-direct.com
  • Direct secure messaging: asuttonsurak1252257@direct.novanthealth.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Davis Health Care CenterWilmington, NC, CCN 345160 Skilled nursing facility Adp of the SNF Jul 1, 2025
Trinity GroveWilmington, NC, CCN 345554 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 25, 2022
Oct 1, 2012

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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

Hospital & facility affiliations 8

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1922080811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 PORTERS NECK RD",
            "address_2": "SUITE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118130",
            "telephone_number": "910-686-1099",
            "fax_number": "910-686-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 PORTERS NECK RD",
            "address_2": "SUITE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28411",
            "telephone_number": "910-686-1099",
            "fax_number": "910-686-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON-SURAK",
        "first_name": "AUDREY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB6325500",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200501955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEATHCARE",
            "identifier": "1378260",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9614555",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5231159",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904062",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.