Susan Michelle Chandler, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-084642 Issued in AL

Practice address

208 Haven Dr
Dothan, AL 36301-2909

Phone

(334) 793-8196

Fax

(334) 699-4757

NPI assigned

Oct 2, 2023

Last updated

Oct 2, 2023By 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

Enrolled in AL

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mchandler12308@southeasthealth.direct-ci.com

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.

• Houston County Healthcare Authority

  dba Samc-Enterprise Medical Clinic

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center Medical Clinics

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349

  Nurse Practitioner

  NPD
• Southeast Alabama Medical Center Employee Pharmacy

  • Pharmacy
  • Dothan, AL
  • NPI 1053526368
  NPD (past)

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1073393690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 HAVEN DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012909",
            "telephone_number": "334-793-8196",
            "fax_number": "334-699-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 HAVEN DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012909",
            "telephone_number": "334-793-8196",
            "fax_number": "334-699-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "SUSAN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-084642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Lynn Chancy, MS, LPC
• Shiva Aravamudan Chandar
• Bradley James Chandler, CRNA
• Chad Chandler, CRNA
• Kassidy Shaye Chandler, MS., CCC-SLP
• Tosha Michelle Chandler, CRNA
• Shruti Chandna, DDS, MS
• Yen Shu Chang Xu
• Lebnitz Joseph Charelus
• Charles Elijah Dentistry

• Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.