CHRISTOPHER MICHAEL SURENDRA (NPI# 1154672426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154672426 |
| Entity Type | Individual |
| Full Name | CHRISTOPHER MICHAEL SURENDRA |
| Credential | PA-C |
| Practice Address |
1110 Se Cary Pkwy Suite 103 Cary NC 27518-7420 |
| Mailing Address |
1120 Se Cary Pkwy Suite 100 Cary NC 27518-7413 |
| Practice Telephone | 9194674992 |
| Practice Fax Number | 9192325328 |
| Mailing Telephone | 9194674992 |
| Mailing Fax Number | 9192325328 |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2020-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 9763 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
C04849 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FL MEDICARE | MD061 | 01 |
| Street Address |
1110 SE CARY PKWY SUITE 103 |
| City | CARY |
| State | NC |
| Zip Code | 27518-7420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114988292 | Virginia A Jethro | Physician Assistant | 1110 Se Cary Pkwy, Suite 206, Cary, NC 27518-7420 | 2006-03-29 |
| 1790031656 | Jennifer S Hill | Physician Assistant | 1110 Se Cary Pkwy, Cary, NC 27518-7420 | 2012-07-30 |
| 1033419569 | Cary Orthopaedic & Sports Medicine Specialists, Pa | Clinic/Center | 1110 Se Cary Pkwy, Ste 103, Cary, NC 27518-7420 | 2010-11-01 |
| 1427366905 | Kimberly Cakerice | Physician Assistant | 1110 Se Cary Pkwy, Suite 203, Cary, NC 27518-7420 | 2010-09-19 |
| 1346566536 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 1110 Se Cary Pkwy, Cary, NC 27518-7420 | 2010-04-13 |
| 1720231749 | Nael Shanti | Orthopaedic Surgery | 1110 Se Cary Pkwy, Suite 103, Cary, NC 27518-7420 | 2008-11-04 |
| 1184811663 | Julie Elizabeth Rockefeller | Speech-Language Pathologist | 1110 Se Cary Pkwy, Cary, NC 27518-7420 | 2007-09-28 |
| 1801091343 | Kelly Pate Nguyen | Nurse Practitioner | 1110 Se Cary Pkwy, Suite 206, Cary, NC 27518-7420 | 2007-06-15 |
| 1780896589 | Jennifer Susanne Taylor | Physician Assistant | 1110 Se Cary Pkwy, Ste. 203, Cary, NC 27518-7420 | 2007-05-04 |
| 1326184870 | Christopher Lin | Physical Medicine & Rehabilitation | 1110 Se Cary Pkwy, Cary, NC 27518-7420 | 2007-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932730801 | Fuller & Associates Iv, Pllc | Dentist | 3420 Ten-ten Road, Suite 310, Cary, NC 27518 | 2020-01-30 |
| 1649761602 | Uday N Reebye, Md. Dmd, Pa | Dentist | 431 Keisler Dr Ste 101, Cary, NC 27518 | 2018-05-25 |
| 1164912093 | Cary Dental Rejuvenation | Dentist | 155 Parkway Office Court, Suite 104, Cary, NC 27518 | 2018-05-16 |
| 1104337021 | Kaylah Mckinley Black | Nurse Practitioner | 530 New Waverly Pl Ste 301, Cary, NC 27518 | 2017-10-18 |
| 1013442961 | Amber Pinsky | Occupational Therapist | 5310 Woodfield Lake Road, Cary, NC 27518 | 2017-04-28 |
| 1750733564 | Maureen Lyons Reardon | Psychologist | 2500 Regency Parkway, Cary, NC 27518 | 2016-07-05 |
| 1730539651 | Anna Liakh | Dentist | 8204 Tryon Woods Dr, Cary, NC 27518 | 2016-06-21 |
| 1609236173 | Matthew John Myschisin II | Chiropractor | 4312 Farm Brook Dr, Cary, NC 27518 | 2016-02-26 |
| 1003299405 | Amanda Lee Morris | Social Worker | 531 Keisler Dr Ste 104, Cary, NC 27518 | 2015-07-02 |
| 1053791343 | Duke University Affiliated Physicians | Family Medicine | 530 Waverly Place, Suite 101, Cary, NC 27518 | 2015-06-02 |
| Find all providers in zip 27518 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336438829 | Claire E Goodwin | Physician Assistant | 115 Cresent Commons Drive, Suite 200, Cary, NC 27518-8102 | 2011-04-05 |
| 1114988292 | Virginia A Jethro | Physician Assistant | 1110 Se Cary Pkwy, Suite 206, Cary, NC 27518-7420 | 2006-03-29 |
| 1073572673 | Cheryl A. Beauman | Physician Assistant | 115 Crescent Commons Dr, Suite 200, Cary, NC 27518-8102 | 2006-03-22 |
| 1356997381 | Melanie Buchanan Overcash | Physician Assistant | 540 New Waverly Pl Ste 200, Cary, NC 27518-7422 | 2019-08-15 |
| 1396390514 | Alexandra Rosse Ginn | Physician Assistant | 1900 Kildaire Farm Rd, Cary, NC 27518-6616 | 2019-08-05 |
| 1972083020 | Courtney Nicole Antoinette Lubick | Physician Assistant | 100 Cornerstone Dr, Cary, NC 27519-8453 | 2018-08-17 |
| 1740738061 | Veronica Crump | Physician Assistant | 3700 Nw Cary Pkwy Ste 110, Cary, NC 27513-8446 | 2016-09-15 |
| 1073978854 | Amy Arruda | Physician Assistant | 400 Keisler Dr, Cary, NC 27518-7069 | 2015-12-22 |
| 1396129300 | Katherine Peregrin | Physician Assistant | 210 Towne Village Dr, Weppa, Cary, NC 27513-8910 | 2015-07-20 |
| 1881932481 | Kelly Weitz | Physician Assistant | 115 Kildaire Park Drive, Suite 301, Cary, NC 27518 | 2013-01-17 |
| Find all providers in CARY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.