Active NPI
Susan Pomeroy Bassett, M.S.
- Audiologist
- Flagstaff, AZ
National Provider Identifier
1003952565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- DA1674
- Practice address
- 1200 N Beaver St
Audiology Department
Flagstaff, AZ 86001-3118 - Phone
- (928) 214-3728
- Fax
- (928) 773-2286
- NPI assigned
- Jan 30, 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | DA1674 | AZ | Primary |
Addresses
Primary practice location
1200 N Beaver St
Audiology Department
Flagstaff, AZ 86001-3118
Mailing address
1200 N Beaver St
Audiology Department
Flagstaff, AZ 86001-3118
Phone (928) 214-3728
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DA1674 | Other | AZ | AUDIOLOGY LICENSE |
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DA1674 | AZ | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003952565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N BEAVER ST",
"address_2": "AUDIOLOGY DEPARTMENT",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013118",
"telephone_number": "928-214-3728",
"fax_number": "928-773-2286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N BEAVER ST",
"address_2": "AUDIOLOGY DEPARTMENT",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013118",
"telephone_number": "928-214-3728",
"fax_number": "928-773-2286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASSETT",
"first_name": "SUSAN",
"middle_name": "POMEROY",
"name_prefix": "Ms.",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "AZ",
"license": "DA1674",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AUDIOLOGY LICENSE",
"identifier": "DA1674",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
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.