Individual provider Active NPI

Susan Carroll Hill, ARNP

  • Family Nurse Practitioner
  • Mount Vernon, WA
National Provider Identifier
1124002563
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
025804 AP30000064 Issued in WA
Practice address
2116 E Section St
Mount Vernon, WA 98274-9124
Phone
(360) 428-1700
Fax
(360) 848-4350
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 025804 AP30000064 WA Primary
Nurse Practitioner 363L00000X AP30000064 WA

Addresses

Primary practice location

2116 E Section St
Mount Vernon, WA 98274-9124

Mailing address

912 32ND St
Anacortes, WA 98221-3473
Phone (360) 293-4343

Other practice location 1

912 32nd St
Anacortes, WA 98221-3473
Phone (360) 293-4343

Other identifiers 13

IdentifierTypeStateIssuer
532300002OtherGROUP HEALTH
8937842OtherCRIME VICTIMS
912109329OtherPREMERA BLUE CROSS
912109329OtherTRIWEST
912109329OtherTAX ID
5403262OtherCCN
5782HIOtherREGENCE BLUE SHIELD
912109329OtherUNIFORM
912109329OtherFIRST CHOICE
0152515OtherLABOR AND INDUSTRIES
912109329OtherCIGNA BEECH ST
9630278OtherDSHS
98250A002OtherTRIWEST

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30000064WAMDNurse Practitioner
025804 AP30000064WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Healthcare Associates PLLC PastSince May 3, 2001 Accepting new patients
Public Hospital District No 2 Skagit County Washington Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shill@islandinternalmedicine.direct.min-ns.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1124002563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 32ND ST",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982213473",
            "telephone_number": "360-293-4343",
            "fax_number": "360-588-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 E SECTION ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982749124",
            "telephone_number": "360-428-1700",
            "fax_number": "360-848-4350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "912 32nd St",
            "address_purpose": "LOCATION",
            "city": "Anacortes",
            "state": "WA",
            "postal_code": "982213473",
            "country_code": "US",
            "telephone_number": "360-293-4343",
            "fax_number": "360-588-1587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILL",
        "first_name": "SUSAN",
        "middle_name": "CARROLL",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "025804 AP30000064",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30000064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "532300002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8937842",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "912109329",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "912109329",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "912109329",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "5403262",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "5782HI",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIFORM",
            "identifier": "912109329",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CHOICE",
            "identifier": "912109329",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0152515",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEECH ST",
            "identifier": "912109329",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS",
            "identifier": "9630278",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "98250A002",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.