Active NPI
Suzanne C. Smith, RN BSN NCSN
- School Registered Nurse
- Sackets Harbor, NY
National Provider Identifier
1184922577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 274339-1
- Practice address
- 215 South Broad Street
Sackets Harbor, NY 13685-0290 - Phone
- (315) 646-3419
- Fax
- (315) 646-1038
- NPI assigned
- Mar 9, 2011
- Last updated
- Mar 9, 2011
- 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 |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 274339-1 | NY | Primary |
Addresses
Primary practice location
215 South Broad Street
Sackets Harbor, NY 13685-0290
Mailing address
215 South Broad Street
Sackets Harbor, NY 13685-0290
Phone (315) 646-3419
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013045327 | Medicaid | NY |
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)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 274339-1 | NY | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299628800000",
"number": "1184922577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 SOUTH BROAD STREET",
"city": "SACKETS HARBOR",
"state": "NY",
"postal_code": "136850290",
"telephone_number": "315-646-3419",
"fax_number": "315-646-1038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 SOUTH BROAD STREET",
"city": "SACKETS HARBOR",
"state": "NY",
"postal_code": "136850290",
"telephone_number": "315-646-3419",
"fax_number": "315-646-1038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SUZANNE",
"middle_name": "C.",
"name_prefix": "Mrs.",
"credential": "RN BSN NCSN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-09",
"last_updated": "2011-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "NY",
"license": "274339-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013045327",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sackets Harbor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.