Individual provider Active NPI

Susan Debarge, CNM

  • Advanced Practice Midwife
  • New Haven, CT
National Provider Identifier
1013944727
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
000223 Issued in CT
Practice address
2 Church St S
#209
New Haven, CT 06519-1717
Phone
(203) 787-2264
Fax
(203) 497-9354
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 000223 CT Primary

Addresses

Primary practice location

2 Church St S
#209
New Haven, CT 06519-1717

Mailing address

2 Church St S
#209
New Haven, CT 06519-1717
Phone (203) 787-2264

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000223CTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013944727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST S",
            "address_2": "#209",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191717",
            "telephone_number": "203-787-2264",
            "fax_number": "203-497-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST S",
            "address_2": "#209",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191717",
            "telephone_number": "203-787-2264",
            "fax_number": "203-497-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBARGE",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "000223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

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.

Verify at the official NPI Registry.