Active NPI
Susan Gateley, A.P.N.
- Primary Care Nurse Practitioner
- Clarksville, AR
National Provider Identifier
1083684740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- A01730
- Practice address
- 601 W McKennon St
Clarksville, AR 72830-3523 - Phone
- (479) 754-8384
- Fax
- (479) 754-7141
- NPI assigned
- Jan 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | A01730 | AR | Primary |
Addresses
Primary practice location
601 W McKennon St
Clarksville, AR 72830-3523
Mailing address
PO Box 668
Clarksville, AR 72830-0668
Phone (479) 754-8384
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020407900 | Other | AR | BLACK LUNG PROGRAM |
| 5U698 | Other | AR | BLUE CROSS BLUE SHIELD AR |
| 0062731 | Other | AR | UMWA H&R FUNDS |
| 0790780001 | Other | AR | PALMETTO GBA |
| 150985758 | Medicaid | AR | |
| 435205 | Other | AR | HEALTH LINK |
| XX12984 | Other | AR | HEALTH PLUS OF MICHIGAN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1083684740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 668",
"city": "CLARKSVILLE",
"state": "AR",
"postal_code": "728300668",
"telephone_number": "479-754-8384",
"fax_number": "479-754-7141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W MCKENNON ST",
"city": "CLARKSVILLE",
"state": "AR",
"postal_code": "728303523",
"telephone_number": "479-754-8384",
"fax_number": "479-754-7141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATELEY",
"first_name": "SUSAN",
"credential": "A.P.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-25",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "AR",
"license": "A01730",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLACK LUNG PROGRAM",
"identifier": "020407900",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD AR",
"identifier": "5U698",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA H&R FUNDS",
"identifier": "0062731",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA",
"identifier": "0790780001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "150985758",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH LINK",
"identifier": "435205",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS OF MICHIGAN",
"identifier": "XX12984",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.