Active NPI
Susan Elizabeth Doubt, RN, CNP
- Family Nurse Practitioner
- Dayton, OH
National Provider Identifier
1134213655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN 294745 NP 06514
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| RN 111598 | MO | MD | Family Nurse Practitioner |
| RN 294745 NP 06514 | OH | MD | Family 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.