Active NPI
Gretchen D Suk, P.A.
- Medical Physician Assistant
- Macon, GA
National Provider Identifier
1982648200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 4018
- Practice address
- 1062 Forsyth St
Suite 1B
Macon, GA 31201-8637 - Phone
- (478) 743-7065
- Fax
- (478) 741-1354
- NPI assigned
- Jun 16, 2006
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 4018 | GA | Primary |
Addresses
Primary practice location
1062 Forsyth St
Suite 1B
Macon, GA 31201-8637
Mailing address
1062 Forsyth St
Suite 1B
Macon, GA 31201-8637
Phone (478) 743-7065
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4018 | GA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205107200000",
"number": "1982648200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1062 FORSYTH ST",
"address_2": "SUITE 1B",
"city": "MACON",
"state": "GA",
"postal_code": "312018637",
"telephone_number": "478-743-7065",
"fax_number": "478-741-1354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1062 FORSYTH ST",
"address_2": "SUITE 1B",
"city": "MACON",
"state": "GA",
"postal_code": "312018637",
"telephone_number": "478-743-7065",
"fax_number": "478-741-1354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUK",
"first_name": "GRETCHEN",
"middle_name": "D",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-16",
"last_updated": "2008-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "GA",
"license": "4018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.