Individual provider Active NPI

Susan M Vineberg, RNFA

  • Perioperative Clinical Nurse Specialist
  • Seattle, WA
National Provider Identifier
1194746768
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Perioperative Clinical Nurse SpecialistTaxonomy code 364SP2800X
License
RN00101365 Issued in WA
Practice address
5028 43Rd Ave S
Seattle, WA 98118-2306
Phone
(206) 999-8428
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 00101365 WA
Medical-Surgical Registered Nurse 163WM0705X RN00101365 WA
Perioperative Clinical Nurse Specialist 364SP2800X 00101365 WA
Perioperative Clinical Nurse Specialist 364SP2800X RN00101365 WA Primary

Addresses

Primary practice location

5028 43Rd Ave S
Seattle, WA 98118-2306

Mailing address

5028 43Rd Ave S
Seattle, WA 98118-2306
Phone (206) 999-8428

Other identifiers 1

IdentifierTypeStateIssuer
00101365OtherWANURSING LISENCE

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

State licenses

LicenseStateTypeSpecialty
00101365WAMDPerioperative Clinical Nurse Specialist
RN00101365WAMDPerioperative Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1194746768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5028 43RD AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182306",
            "telephone_number": "206-999-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5028 43RD AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182306",
            "telephone_number": "206-999-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINEBERG",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "00101365",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "WA",
            "license": "RN00101365",
            "primary": false
        },
        {
            "code": "364SP2800X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Perioperative",
            "state": "WA",
            "license": "00101365",
            "primary": false
        },
        {
            "code": "364SP2800X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Perioperative",
            "state": "WA",
            "license": "RN00101365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LISENCE",
            "identifier": "00101365",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.