Callista M Susen

Primary specialty

Technician/TechnologistTaxonomy code 156F00000X

License

RBT-21-167101 Issued in NC

Practice address

6985 Nexus CT Ste 107
Fayetteville, NC 28304-3186

Phone

(910) 493-3999

Fax

(910) 728-4644

NPI assigned

Sep 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1174293583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6985 NEXUS CT STE 107",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043186",
            "telephone_number": "910-493-3999",
            "fax_number": "910-728-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6985 NEXUS CT STE 107",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043186",
            "telephone_number": "910-493-3999",
            "fax_number": "910-728-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSEN",
        "first_name": "CALLISTA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "NC",
            "license": "RBT-21-167101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09162021",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "deniseferguson@lifespanabanc.org",
            "affiliation": "N",
            "endpointDescription": "Contact information for messaging",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6985 Nexus Ct Ste 107",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283043186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "deniseferguson@lifespanabanc.org",
            "affiliation": "N",
            "endpointDescription": "Direct message address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6985 Nexus Ct Ste 107",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283043186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "deniseferguson@lifespanabanc.org",
            "affiliation": "N",
            "endpointDescription": "Direct messaging address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6985 Nexus Ct Ste 107",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283043186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Technician/Technologist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Technician/Technologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.