Individual provider Active NPI

Susan T Cavanagh, N.P., C.N.M.

  • Advanced Practice Midwife
  • Cortlandt Manor, NY
National Provider Identifier
1013054808
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F000117-1 Issued in NY
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, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
277534-1NYMDHigh-Risk Obstetric Registered Nurse
F360158-1NYMDObstetrics & Gynecology Nurse Practitioner
F000117-1NYMDAdvanced 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.

Verify at the official NPI Registry.