Susan Elizabeth Northrup, M.D., M.P.H

Primary specialty

Aerospace Medicine PhysicianTaxonomy code 2083A0100X

License

54426 Issued in GA

Practice address

1701 Columbia Avenue
Federal Aviation Administration, Aso-300
College Park, GA 30337

Phone

(404) 305-6150

Fax

(404) 305-6161

NPI assigned

Mar 28, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1104288240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 COLUMBIA AVE",
            "address_2": "FEDERAL AVIATION ADMINISTRATION, ASO-300",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303372714",
            "telephone_number": "404-305-6150",
            "fax_number": "404-305-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 COLUMBIA AVENUE",
            "address_2": "FEDERAL AVIATION ADMINISTRATION, ASO-300",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "30337",
            "telephone_number": "404-305-6150",
            "fax_number": "404-305-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHRUP",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "GA",
            "license": "54426",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "GA",
            "license": "54426",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in College Park, GA by specialty
• Aerospace Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.