Susan Homolka, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

200350028NP Issued in OR

Practice address

1670 High St
Eugene, OR 97401-4151

Phone

(541) 344-9411

NPI assigned

Jan 31, 2007

Last updated

Jul 20, 2009By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248048000000",
    "number": "1174660179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3456 OLYMPIC ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974785574",
            "telephone_number": "541-729-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 HIGH ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014151",
            "telephone_number": "541-344-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMOLKA",
        "first_name": "SUSAN",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2009-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "200350028NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292793",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holub McKim L.L.C.
• Andrew Holub, D.D.S.
• Christine Anne Holub
• Home Parenteral Care, Inc
• Homes for Good Housing Agency
• Nicholas N. Hong, PH.D.
• Sooji Hong, PA
• Aaron Honn, PHD
• Honu Healing LLC
• Sheila Kay Hood, M.A.T.

• Adult Health Nurse Practitioner in Eugene, OR
• Providers in Eugene, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2009; 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.