Active NPI
Susanne Harrison, M.D.
- Internal Medicine Physician
- Colebrook, CT
National Provider Identifier
1154774743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036190
- Practice address
- 897 Colebrook Rd
Colebrook, CT 06021-1021 - Phone
- (860) 605-7969
- Fax
- (860) 605-7969
- NPI assigned
- Jul 19, 2016
- Last updated
- Jul 19, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036190 | CT | Primary |
Addresses
Primary practice location
897 Colebrook Rd
Colebrook, CT 06021-1021
Mailing address
897 Colebrook Rd
Colebrook, CT 06021-1021
Phone (860) 605-7969
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036190 | CT | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468886400000",
"number": "1154774743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "897 COLEBROOK RD",
"city": "COLEBROOK",
"state": "CT",
"postal_code": "060211021",
"telephone_number": "860-605-7969",
"fax_number": "860-605-7969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "897 COLEBROOK RD",
"city": "COLEBROOK",
"state": "CT",
"postal_code": "060211021",
"telephone_number": "860-605-7969",
"fax_number": "860-605-7969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "SUSANNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-19",
"last_updated": "2016-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "036190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colebrook, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.