Individual provider Active NPI

Susan Rivers-Payne, MSN

  • Nurse Practitioner
  • Walnut Hills, OH
National Provider Identifier
1083648109
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN084379NP05398 Issued in OH
Practice address
1501 Madison Rd FL 3
Walnut Hills, OH 45206-1780
Phone
(513) 354-5238
Fax
(513) 354-5237
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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 RN084379NP05398 OH Primary

Addresses

Primary practice location

1501 Madison Rd FL 3
Walnut Hills, OH 45206-1780

Mailing address

519 Howell Ave
Cincinnati, OH 45220-1905
Phone (513) 861-3001

Other identifiers 2

IdentifierTypeStateIssuer
2153771MedicaidOH
7801148OtherKYMEDICAID

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)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN084379NP05398OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth Physician Institute Nurse Practitioner Past Accepting new patients
University of Cincinnati Physicians Company, LLC Nurse Practitioner Past Accepting new patients

Organizations & group practices 2

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1083648109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 HOWELL AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452201905",
            "telephone_number": "513-861-3001",
            "fax_number": "513-559-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MADISON RD FL 3",
            "city": "WALNUT HILLS",
            "state": "OH",
            "postal_code": "452061780",
            "telephone_number": "513-354-5238",
            "fax_number": "513-354-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERS-PAYNE",
        "first_name": "SUSAN",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "RN084379NP05398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2153771",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "7801148",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Hills, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.

Verify at the official NPI Registry.