Individual provider Active NPI

Susan Lynn Henry, CRNP

  • Nurse Practitioner
  • Chestertown, MD
National Provider Identifier
1073403978
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R148757 Issued in MD
Practice address
415 Morgnec Rd
Chestertown, MD 21620-1046
Phone
(410) 778-1900
NPI assigned
Jul 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R148757 MD Primary

Addresses

Primary practice location

415 Morgnec Rd
Chestertown, MD 21620-1046

Mailing address

11419 River Rd
Ridgely, MD 21660-1826
Phone (443) 786-2681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20260420003802 MD Practitioner - Nurse Practitioner 3870069412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kinetic Primary CareGroup PAC ID 5294192779, 9 clinicians

Practice addresses (Care Compare)

30 N PL
Frederick, MD 21701-6200
Phone (804) 742-2613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R148757MDMDNurse Practitioner

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1751500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1073403978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11419 RIVER RD",
            "city": "RIDGELY",
            "state": "MD",
            "postal_code": "216601826",
            "telephone_number": "443-786-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MORGNEC RD",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201046",
            "telephone_number": "410-778-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R148757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestertown, MD

Sources for this page

Verify at the official NPI Registry.