Individual provider Active NPI

Susan Smith Rice, APRN

  • Nurse Practitioner
  • Beaver Dam, KY
National Provider Identifier
1205909330
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3003830 Issued in KY
Practice address
1219 North Main St
Norsworthy Medical Assoc., PSC
Beaver Dam, KY 42320
Phone
(270) 274-0638
Fax
(270) 274-5600
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3830P KY
Family Nurse Practitioner 363LF0000X 3830P KY
Nurse Practitioner 363L00000X 3003830 KY Primary

Addresses

Primary practice location

1219 North Main St
Norsworthy Medical Assoc., PSC
Beaver Dam, KY 42320

Mailing address

1219 North Main St
Beaver Dam, KY 42320
Phone (270) 274-0638

Other identifiers 2

IdentifierTypeStateIssuer
78008190MedicaidKY
1205909330MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070131000608 KY Practitioner - Nurse Practitioner 1557363751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Norsworthy Medical Associates PSCGroup PAC ID 1355318080, 4 clinicians

Practice addresses (Care Compare)

1219 N Main St
Beaver Dam, KY 42320-8955
Phone (270) 274-1800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3003830KYMDNurse Practitioner
3830PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norsworthy Medical Associates PSC CurrentSince Sep 4, 2002 Accepting new patients
Fyi Healthcare Clinic, PLLC Family Past Accepting new patients

Locations

1219 N Main St
Beaver Dam, KY 42320
Phone (270) 274-1800

1219 N Main St
Ste 101
Beaver Dam, KY 42320
Phone (270) 274-0638

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1205909330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 NORTH MAIN ST",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "42320",
            "telephone_number": "270-274-0638",
            "fax_number": "270-274-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 NORTH MAIN ST",
            "address_2": "NORSWORTHY MEDICAL ASSOC., PSC",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "42320",
            "telephone_number": "270-274-0638",
            "fax_number": "270-274-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "SUSAN",
        "middle_name": "SMITH",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3830P",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3830P",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3003830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78008190",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205909330",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, KY

Sources for this page

Verify at the official NPI Registry.