Active NPI
Susan R. Welch, ARNP
- Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1174638159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP1620982
- Practice address
- 807 Childrens Way
Jacksonville, FL 32207-8426 - Phone
- (904) 858-3988
- Fax
- (904) 858-3140
- NPI assigned
- Aug 20, 2006
- Last updated
- Apr 30, 2008
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP1620982 | FL | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | ARNP1620982 | FL |
Addresses
Primary practice location
807 Childrens Way
Jacksonville, FL 32207-8426
Mailing address
Nemours Children&Apos S Clinic
PO Box 409992
Atlanta, GA 30384-0001
Phone (904) 390-3610
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 302267600 | Medicaid | FL | |
| 183354418A | Medicaid | GA |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nemours Foundation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1174638159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NEMOURS CHILDREN&APOS S CLINIC",
"address_2": "PO BOX 409992",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303840001",
"telephone_number": "904-390-3610",
"fax_number": "904-288-5890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 CHILDRENS WAY",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078426",
"telephone_number": "904-858-3988",
"fax_number": "904-858-3140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELCH",
"first_name": "SUSAN",
"middle_name": "R.",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP1620982",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "ARNP1620982",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "302267600",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "183354418A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.