Individual provider Active NPI

Susan G Taney, FNP

  • Family Nurse Practitioner
  • Concord, VT
National Provider Identifier
1174589097
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
101-0020784 Issued in VT
Practice address
201 East Main Street
Concord, VT 05824-0355
Phone
(802) 695-2512
Fax
(802) 695-1303
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 101-0020784 VT Primary

Addresses

Primary practice location

201 East Main Street
Concord, VT 05824-0355

Mailing address

165 Sherman Dr
St Johnsbury, VT 05819-9811
Phone (802) 748-9405

Other identifiers 1

IdentifierTypeStateIssuer
0NP0518MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101123000584 VT Practitioner - Nurse Practitioner 7618163106 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Nov 1, 2017 Accepting new patients
Baart Behavioral Health Services, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc CurrentSince Nov 1, 2017 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Baart Behavioral Health Services, Inc. CurrentSince Mar 21, 2020 Accepting new patients
Northeastern Vermont Regional Hospital Inc Current Accepting new patients
Baart Behavioral Health Services, Inc. Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Baart Behavioral Health Services, Inc. CurrentSince Mar 21, 2020 Accepting new patients

Locations

1720 Lakepointe Dr
Ste 117
Lewisville, TX 75057

475 Union St
Newport, VT 05855
Phone (802) 334-0110

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

1097 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 397-9484

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1174589097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SHERMAN DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199811",
            "telephone_number": "802-748-9405",
            "fax_number": "802-748-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 EAST MAIN STREET",
            "city": "CONCORD",
            "state": "VT",
            "postal_code": "058240355",
            "telephone_number": "802-695-2512",
            "fax_number": "802-695-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANEY",
        "first_name": "SUSAN",
        "middle_name": "G",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101-0020784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0NP0518",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, VT

Sources for this page

Verify at the official NPI Registry.