Active NPI
Susan Jo Start, MD
- Pediatrics Physician
- Fort Mill, SC
National Provider Identifier
1972536878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 22022
- Practice address
- 1698 Highway 160 W
Suite 220
Fort Mill, SC 29708-8032 - Phone
- (803) 802-5900
- Fax
- (803) 802-7101
- NPI assigned
- Jul 7, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 22022 | SC | Primary |
Addresses
Primary practice location
1698 Highway 160 W
Suite 220
Fort Mill, SC 29708-8032
Mailing address
1601 Ebenezer Rd
Rock Hill, SC 29732-1808
Phone (803) 328-6281
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220228 | Medicaid | SC | |
| 067TP | Other | NC | BC/BS |
Other names 1
- Susan Jo Deur
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charlotte Radiology P a | Past | Accepting new patients | |
| Carolinas Physicians Network Inc | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Atrium Health Levine Childrens Gastonia Childrens Clinic
- Pediatrics Physician
- Gastonia, NC
- NPI 1811145014
-
- Specialist
- Charlotte, NC
- NPI 1649220443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972536878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 EBENEZER RD",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321808",
"telephone_number": "803-328-6281",
"fax_number": "803-981-5136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1698 HIGHWAY 160 W",
"address_2": "SUITE 220",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297088032",
"telephone_number": "803-802-5900",
"fax_number": "803-802-7101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "START",
"first_name": "SUSAN",
"middle_name": "JO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "22022",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "220228",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "067TP",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "DEUR",
"middle_name": "JO",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Mill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.