Individual provider Active NPI

Susan M. Miner, APRN, FNP-C

  • Family Nurse Practitioner
  • Afton, WY
National Provider Identifier
1063012383
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
46373 Issued in WY
Practice address
47 Doc Perkes
Afton, WY 83110-7703
Phone
(307) 883-5500
NPI assigned
Oct 27, 2020
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 46373 WY Primary

Addresses

Primary practice location

47 Doc Perkes
Afton, WY 83110-7703

Mailing address

942 Saddle Dr
Etna, WY 83118-8713
Phone (307) 349-4682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210507001024 ID Practitioner - Nurse Practitioner 7315356136 Reassigns benefits to 1 organization
I20240709003796 WY Practitioner - Nurse Practitioner 7315356136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sterling Provider GroupGroup PAC ID 2264773373, 52 clinicians

Practice addresses (Care Compare)

47 Doc Perkes
Afton, WY 83110-7703
Phone (307) 885-3637

740 S Woodruff Ave
Idaho Falls, ID 83401-5285
Phone 20854291111026

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
46373WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Provider Group CurrentSince May 20, 2024 Accepting new patients
Urgent Care Associates PLLC Current Accepting new patients
Sterling Provider Group CurrentSince May 20, 2024 Accepting new patients

Locations

7017 Daisy Ln
Idaho Falls, ID 83402
Phone (208) 534-5878

740 S Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 542-9111

47 Doc Perkes
Afton, WY 83110
Phone (307) 734-5864

1952 Harrison Dr
Evanston, WY 82930
Phone (307) 288-0404

2761 Commercial Way
Rock Springs, WY 82901
Phone (307) 382-3064

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1063012383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 SADDLE DR",
            "city": "ETNA",
            "state": "WY",
            "postal_code": "831188713",
            "telephone_number": "307-349-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 DOC PERKES",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831107703",
            "telephone_number": "307-883-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "46373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Afton, WY

Sources for this page

Verify at the official NPI Registry.