Susan Katherine Frady, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

10059 Issued in CO

Practice address

715 S 9TH St
Canon City, CO 81212-4911

Phone

(719) 269-8820

Fax

(719) 204-0230

NPI assigned

Jun 14, 2010

Last updated

Mar 29, 2016By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Metamorphosis LTDGroup PAC ID 1456573427, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Metamorphosis LTD

  • Certified Registered Nurse Anesthetist
  • Canon City, CO
  • NPI 1013324268
  Medicare reassignment Care Compare group NPD
• Canon Professional Wellness Clinic LLC

  • Primary Care Nurse Practitioner
  • Canon City, CO
  • NPI 1780384560
  Medicare reassignment NPD
• Metamorphosis LTD

  • Interventional Pain Medicine Physician
  • Colorado Springs, CO
  • NPI 1003415860

  Nurse Practitioner

  NPD
• Canon Professional, L.L.C.

  • Primary Care Clinic/Center
  • Canon City, CO
  • NPI 1568625549
  NPD (past)

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1083935001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 ELM AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124829",
            "telephone_number": "303-981-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S 9TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124911",
            "telephone_number": "719-269-8820",
            "fax_number": "719-204-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRADY",
        "first_name": "SUSAN",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "10059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60539577",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pam Forbes, LPC
• Leila D Ford, MD
• Fortissimo Healthcare PLLC
• Jennifer Lynn Foster, RDH
• Foxtrot Anesthesia
• Margaret Frasure, LCSW
• Fremont County
• Fremont Regional Hospice
• Fresh Start Counseling LLC
• Robert Furby, M.S. FAAA

• Nurse Practitioner in Canon City, CO
• Providers in Canon City, CO by specialty
• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.