Individual provider Active NPI

Susan M Bothun, APRN, AGCNS-BC, DNP

  • Acute Care Clinical Nurse Specialist
  • Rochester, MN
National Provider Identifier
1013708387
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
638 Issued in MN
Practice address
1216 2ND St SW
Mb8Bg
Rochester, MN 55902-1906
Phone
(507) 422-0579
NPI assigned
May 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 638 MN Primary

Addresses

Primary practice location

1216 2ND St SW
Mb8Bg
Rochester, MN 55902-1906

Mailing address

1216 2ND St SW
Rochester, MN 55902-1906

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1013708387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 2ND ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559021906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 2ND ST SW",
            "address_2": "MB8BG",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559021906",
            "telephone_number": "507-422-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTHUN",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "APRN, AGCNS-BC, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "MN",
            "license": "638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.