Active NPI
Susan Elizabeth Hannam, HSD
- Athletic Trainer
- Slippery Rock, PA
National Provider Identifier
1205913803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT000441A
- Practice address
- 1 Morrow Way
Slippery Rock University
Slippery Rock, PA 16057-1313 - Phone
- (724) 738-2794
- Fax
- (724) 738-2881
- NPI assigned
- Nov 1, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT000441A | PA | Primary |
Addresses
Primary practice location
1 Morrow Way
Slippery Rock University
Slippery Rock, PA 16057-1313
Mailing address
232 E Water St
Slippery Rock, PA 16057-1151
Phone (724) 794-3931
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PROVIDER CODE 22 | Other | PA | PROVIDER CODE 22 |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RT000441A | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205913803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 E WATER ST",
"city": "SLIPPERY ROCK",
"state": "PA",
"postal_code": "160571151",
"telephone_number": "724-794-3931",
"fax_number": "724-738-2881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MORROW WAY",
"address_2": "SLIPPERY ROCK UNIVERSITY",
"city": "SLIPPERY ROCK",
"state": "PA",
"postal_code": "160571313",
"telephone_number": "724-738-2794",
"fax_number": "724-738-2881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNAM",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "HSD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT000441A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER CODE 22",
"identifier": "PROVIDER CODE 22",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Slippery Rock, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.