Active NPI
Susan Roberta Tussey, FNP
- Family Nurse Practitioner
- San Diego, CA
National Provider Identifier
1053307504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- VP003542B
- Practice address
- 4525 Campus Ave
#8
San Diego, CA 92116 - Phone
- (808) 228-5661
- Fax
- (808) 257-5653
- NPI assigned
- Sep 21, 2005
- Last updated
- May 6, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | VP003542B | PA | Primary |
Addresses
Primary practice location
4525 Campus Ave
#8
San Diego, CA 92116
Mailing address
4525 Campus Ave
#8
San Diego, CA 92116-1127
Phone (808) 228-5661
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VP003542B | PA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273104000000",
"number": "1053307504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4525 CAMPUS AVE",
"address_2": "#8",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921161127",
"telephone_number": "808-228-5661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4525 CAMPUS AVE",
"address_2": "#8",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92116",
"telephone_number": "808-228-5661",
"fax_number": "808-257-5653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUSSEY",
"first_name": "SUSAN",
"middle_name": "ROBERTA",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-21",
"last_updated": "2010-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "VP003542B",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.