Individual provider Active NPI

Susan Henry Koegler, R.N., M.S.

  • Oncology Registered Nurse
  • Boston, MA
National Provider Identifier
1063500429
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Registered NurseTaxonomy code 163WX0200X
License
105786 Issued in MA
Practice address
150 S Huntington Ave
Vabhs (151Mav)
Boston, MA 02130-4817
Phone
(857) 364-4386
Fax
(857) 364-6528
NPI assigned
Oct 11, 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
Oncology Registered Nurse 163WX0200X 105786 MA Primary

Addresses

Primary practice location

150 S Huntington Ave
Vabhs (151Mav)
Boston, MA 02130-4817

Mailing address

28 Kates GLN
Plymouth, MA 02360-8264

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
Credentials
Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
105786MAMDOncology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063500429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 KATES GLN",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023608264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "address_2": "VABHS (151MAV)",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-364-4386",
            "fax_number": "857-364-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEGLER",
        "first_name": "SUSAN",
        "middle_name": "HENRY",
        "credential": "R.N., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "MA",
            "license": "105786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

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.