Susan Carol Imke, F.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

229206 Issued in TX

Practice address

1305 Airport Fwy
Suite 205
Bedford, TX 76021-6605

Phone

(817) 267-6290

Fax

(817) 267-0950

NPI assigned

May 6, 2009

Last updated

Dec 20, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1043444961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 AIRPORT FWY",
            "address_2": "SUITE 205",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216605",
            "telephone_number": "817-267-6290",
            "fax_number": "817-267-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 AIRPORT FWY",
            "address_2": "SUITE 205",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216605",
            "telephone_number": "817-267-6290",
            "fax_number": "817-267-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMKE",
        "first_name": "SUSAN",
        "middle_name": "CAROL",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "229206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meryum Ijazi, PHARMD
• Victoria Ike
• Henrik B Illum, M.D.
• Mihaiela Ilves, CSFA, CST
• Iman Ali MD PA
• Impulse Home Care LLC (Synergy Homecare of Southlake)
• Impulse Pharmacy Incorporated (Impulse Pharmacy)
• Daniel Ingel, DMD
• Inkosi Lux Home Health LLC
• Asha Daniella Inniss, NP

• Nurse Practitioner in Bedford, TX
• Providers in Bedford, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.