NPIMap

Individual provider Active NPI

Susanne P Johnson, FNP

  • Family Nurse Practitioner
  • Manning, SC
National Provider Identifier
1205069770
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3937 Issued in SC
Practice address
50 E Hospital St Ste 3
Manning, SC 29102-3149
Phone
(803) 435-8828
Fax
(803) 435-2239
NPI assigned
Aug 31, 2009
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3937 SC Primary

Addresses

Primary practice location

50 E Hospital St Ste 3
Manning, SC 29102-3149

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (803) 435-5270

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address susanne.johnson@mpaii.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101115001048 SC Practitioner - Nurse Practitioner 2769677855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Health ClarendonGroup PAC ID 0840582656, 60 clinicians

Practice addresses (Care Compare)

50 E Hospital St
Suite 3
Manning, SC 29102-3149
Phone (803) 435-8828

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3937SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Clarendon CurrentSince Dec 25, 2018 Accepting new patients
McLeod Health Clarendon CurrentSince Dec 25, 2018 Accepting new patients
McLeod Health Clarendon Current Accepting new patients

Locations

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

200 E Hospital St
Manning, SC 29102
Phone (803) 433-0439

22 Bozard St
Manning, SC 29102
Phone (803) 435-8828

50 E Hospital St
Ste 3
Manning, SC 29102
Phone (803) 435-5236

Interoperability endpoints

  • Direct secure messaging: sjohnson26122@directmcleodehealth.org
  • Direct secure messaging: susanne.johnson@mpaii.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1205069770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "803-435-5270",
            "fax_number": "803-433-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E HOSPITAL ST STE 3",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023149",
            "telephone_number": "803-435-8828",
            "fax_number": "803-435-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUSANNE",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susanne.johnson@mpaii.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "ECW DA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "22 Bozard St",
            "city": "Manning",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291022935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manning, SC

Sources for this page

Verify at the official NPI Registry.