Active NPI
Susan S Spause, F.N.P.
- Family Nurse Practitioner
- Seaford, DE
National Provider Identifier
1093924425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- LG-0000721
- Practice address
- 105 N Front St BLDG 3
Seaford, DE 19973-2707 - Phone
- (833) 886-2277
- NPI assigned
- May 22, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | LG-0000721 | DE | Primary |
| Family Nurse Practitioner | 363LF0000X | F332500 | NY |
Addresses
Primary practice location
105 N Front St BLDG 3
Seaford, DE 19973-2707
Mailing address
17907 Ebb Tide Dr
Lewes, DE 19958-4183
Phone (212) 300-5725
Other practice location 1
17907 Ebb Tide Dr
Lewes, DE 19958-4183
Phone (212) 300-5725
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LG-0000721 | Medicaid | DE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | sspause@coraswellness.org |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LG-0000721 | DE | MD | Family Nurse Practitioner |
| F332500 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677888000000",
"number": "1093924425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17907 EBB TIDE DR",
"city": "LEWES",
"state": "DE",
"postal_code": "199584183",
"telephone_number": "212-300-5725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N FRONT ST BLDG 3",
"city": "SEAFORD",
"state": "DE",
"postal_code": "199732707",
"telephone_number": "833-886-2277"
}
],
"practiceLocations": [
{
"address_1": "17907 Ebb Tide Dr",
"address_purpose": "LOCATION",
"city": "Lewes",
"state": "DE",
"postal_code": "199584183",
"country_code": "US",
"telephone_number": "212-300-5725",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SPAUSE",
"first_name": "SUSAN",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "F.N.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2023-03-04",
"certification_date": "2022-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "DE",
"license": "LG-0000721",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F332500",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LG-0000721",
"state": "DE"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "sspause@coraswellness.org",
"affiliation": "N",
"address_1": "105 N Front St Bldg 3",
"city": "Seaford",
"state": "DE",
"country_code": "US",
"postal_code": "199732707",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Seaford, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.