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BRUNSWICK FAMILY MEDICINE PA
NPI 1396859872
Family Medicine in Southport, NC

Active since August 19, 2006CLIA 34D1061518 · Microscopy
3960 EXECUTIVE PARK BLVD, UNIT 600, SOUTHPORT, NC 28461(910) 454-4343(910) 457-9209 Get Directions Write a Review

NPPES record last updated: September 25, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Brunswick Family Medicine Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRUNSWICK FAMILY MEDICINE PA (NPI 1396859872) is a healthcare organization registered as a family medicine in Southport, North Carolina and active in the NPI registry since August 2006. The organization holds a CLIA Microscopy certificate valid through November 19, 2026 and lists Slade Alan Suchecki, President, as its authorized official.

NPPES Registry Identity

NPI1396859872
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBRUNSWICK FAMILY MEDICINE PA
Location Address3960 EXECUTIVE PARK BLVD, UNIT 600Southport, NC 28461
Mailing Address3960 Executive Park Blvd, Unit 600Southport, NC 28461 · (910) 454-4343 · Fax (910) 457-9209
Phone(910) 454-4343
Fax(910) 457-9209
Organization SubpartNo
Authorized OfficialSlade Alan SucheckiPresident · (910) 454-4343
Enumeration DateAugust 19, 2006
Last NPPES UpdateSeptember 25, 2014
✔ NPI 1396859872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3960 EXECUTIVE PARK BLVD, Southport, NC 28461
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 34D1061518

Brunswick Family Medicine · Southport, NC
Active · expires Nov 19, 2026
CLIA Number34D1061518
Laboratory TypePhysician Office
Certificate Effective DateNovember 20, 2024
Certificate Expiration DateNovember 19, 2026
Laboratory DirectorSlade A. Suchecki Do
Laboratory Phone(910) 454-4343
Laboratory LocationBrunswick Family Medicine3960 Executive Park Blvd Ste 600, Southport, NC 28461
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SLADE ALAN SUCHECKI D.O.
Family Medicine
3960 EXECUTIVE PARK BLVD, SUITE 600
SOUTHPORT, NC 28461
Brunswick County (910) 454-4343
RICK J HERNANDEZ M.D.
Family Medicine
3960 EXECUTIVE PARK BLVD, SUITE 600
SOUTHPORT, NC 28461
Brunswick County (910) 454-4343

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brunswick Family Medicine PA's NPI number?

The NPI number for Brunswick Family Medicine PA is 1396859872. It was assigned to this organization in the NPPES registry on August 19, 2006.

Where is Brunswick Family Medicine PA located?

Brunswick Family Medicine PA is located at 3960 Executive Park Blvd Unit 600, Southport, NC 28461. The listed phone number is (910) 454-4343.

What is Brunswick Family Medicine PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Brunswick Family Medicine PA hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 34D1061518) is associated with this NPI, valid through November 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Brunswick Family Medicine PA accept?

Health plans from Blue Cross and Blue Shield of NC list Brunswick Family Medicine PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brunswick Family Medicine PA was last updated on September 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.