Individual provider Active NPI

Susan Elizabeth Doubt, RN, CNP

  • Family Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1134213655
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN 294745 NP 06514 Issued in OH
Practice address
4100 West Third Street
Dayton VA Medical Center
Dayton, OH 45428
Phone
(937) 268-6511
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 RN 294745 NP 06514 OH Primary
Family Nurse Practitioner 363LF0000X RN 111598 MO

Addresses

Primary practice location

4100 West Third Street
Dayton VA Medical Center
Dayton, OH 45428

Mailing address

626 Omar Circle
Yellow Springs, OH 45387-1420
Phone (937) 767-1540

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
Credentials
Certified Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 111598MOMDFamily Nurse Practitioner
RN 294745 NP 06514OHMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134213655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 OMAR CIRCLE",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871420",
            "telephone_number": "937-767-1540",
            "fax_number": "937-767-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 WEST THIRD STREET",
            "address_2": "DAYTON VA MEDICAL CENTER",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45428",
            "telephone_number": "937-268-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUBT",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "RN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "RN 294745 NP 06514",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "RN 111598",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.