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Kavita Sura

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

40 Autumn Fern Trl, Lillington, NC 27546-5155

PECOS Enrollment

Based on the most recent information from CMS, provider Kavita Sura is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1811433345
Provider Type
Individual
Full Name
Sura, Kavita
Gender
Female

Sole Proprietor
Yes
Enumeration Date
1/8/2017
Last Updated
1/28/2017

Contact Information

Practice Location

40 Autumn Fern Trl, Lillington, NC 27546-5155

(919) 995-1436

Unlisted Fax

Mailing Location

40 Autumn Fern Trl, Lillington, NC 27546-5155

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 0010-06879 North Carolina

Kavita Sura

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Mock, Logan

Farawi, Dania Mahmoud

Bentley, Justin

Irwin, Hope

Cothran, Ashley L

Kivuti, Valerie Wawira

Groce, Christopher Fraser

Stanley, Karson Makenna

Johnson, Mackinsey Diane

Reynolds, Abigail Mary Ann