Active NPI
Susan T Cavanagh, N.P., C.N.M.
- Advanced Practice Midwife
- Cortlandt Manor, NY
National Provider Identifier
1013054808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- F000117-1
- Practice address
- 1985 Crompond Rd
Building B
Cortlandt Manor, NY 10567-4146 - Phone
- (914) 739-1697
- Fax
- (914) 739-0973
- NPI assigned
- Jan 31, 2007
- Last updated
- Jul 3, 2013
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | F360158-1 | NY | |
| Advanced Practice Midwife | 367A00000X | F000117-1 | NY | Primary |
| High-Risk Obstetric Registered Nurse | 163WX0002X | 277534-1 | NY |
Addresses
Primary practice location
1985 Crompond Rd
Building B
Cortlandt Manor, NY 10567-4146
Mailing address
1985 Crompond Rd
Cortlandt Manor, NY 10567-4146
Phone (914) 739-1697
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
- Certified Nurse Midwife, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277534-1 | NY | MD | High-Risk Obstetric Registered Nurse |
| F360158-1 | NY | MD | Obstetrics & Gynecology Nurse Practitioner |
| F000117-1 | NY | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372809600000",
"number": "1013054808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1985 CROMPOND RD",
"city": "CORTLANDT MANOR",
"state": "NY",
"postal_code": "105674146",
"telephone_number": "914-739-1697",
"fax_number": "914-739-0973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1985 CROMPOND RD",
"address_2": "BUILDING B",
"city": "CORTLANDT MANOR",
"state": "NY",
"postal_code": "105674146",
"telephone_number": "914-739-1697",
"fax_number": "914-739-0973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAGH",
"first_name": "SUSAN",
"middle_name": "T",
"credential": "N.P., C.N.M.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2013-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "NY",
"license": "F360158-1",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NY",
"license": "F000117-1",
"primary": true
},
{
"code": "163WX0002X",
"taxonomy_group": "",
"desc": "Registered Nurse, Obstetric, High-Risk",
"state": "NY",
"license": "277534-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cortlandt Manor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.