Active NPI
Susan Hathaway
- Attendant Care Provider
- Portland, IN
National Provider Identifier
1093365355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- Practice address
- 3783 West 800 South
Portland, IN 47371 - Phone
- (260) 729-1153
- NPI assigned
- Sep 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Primary |
Addresses
Primary practice location
3783 West 800 South
Portland, IN 47371
Mailing address
P.O. Box 24
Portland, IN 47371
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568764800000",
"number": "1093365355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 24",
"city": "PORTLAND",
"state": "IN",
"postal_code": "47371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3783 WEST 800 SOUTH",
"city": "PORTLAND",
"state": "IN",
"postal_code": "47371",
"telephone_number": "260-729-1153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATHAWAY",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-18",
"last_updated": "2019-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.