Active NPI
Susanne K Vanderbilt, M.D.
- Hospitalist Physician
- Jber, AK
National Provider Identifier
1184867871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 56668-20
- Practice address
- 5955 Zeamer Ave
Jber, AK 99506-3702 - Phone
- (907) 580-5556
- NPI assigned
- Apr 11, 2009
- 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 |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 56668-20 | WI | Primary |
Addresses
Primary practice location
5955 Zeamer Ave
Jber, AK 99506-3702
Mailing address
5955 Zeamer Ave
Jber, AK 99506-3702
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56668-20 | WI | MD | Hospitalist Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443571200000",
"number": "1184867871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5955 ZEAMER AVE",
"city": "JBER",
"state": "AK",
"postal_code": "995063702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5955 ZEAMER AVE",
"city": "JBER",
"state": "AK",
"postal_code": "995063702",
"telephone_number": "907-580-5556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERBILT",
"first_name": "SUSANNE",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-11",
"last_updated": "2015-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WI",
"license": "56668-20",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jber, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.