Individual provider Active NPI

Susan Lara Albright, ANP

  • Family Nurse Practitioner
  • Grants Pass, OR
National Provider Identifier
1265739742
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201501648NP Issued in OR
Practice address
537 Union Ave
Grants Pass, OR 97527-5543
Phone
(541) 507-2170
NPI assigned
Feb 18, 2011
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.12204-NP OH
Family Nurse Practitioner 363LF0000X 201501648NP OR Primary

Addresses

Primary practice location

537 Union Ave
Grants Pass, OR 97527-5543

Mailing address

2825 E Barnett Rd Ofc
Medford, OR 97504-8332
Phone (541) 789-8176

Other practice location 1

1890 NW 6th St
Grants Pass, OR 97526-1038
Phone (541) 507-0684

Other identifiers 1

IdentifierTypeStateIssuer
500686240MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20150623001729 OR Practitioner - Nurse Practitioner 8123216058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

1740 NW Goetz St
Roseburg, OR 97471-1613
Phone (541) 672-4885

1755 SW Baker St
McMinnville, OR 97128-9112
Phone (971) 900-4522

1800 Coburg Rd
Eugene, OR 97401-4995
Phone (541) 345-8760

1841 E Barnett Rd
Medford, OR 97504-8249
Phone (541) 216-7291

1890 NW 6TH St
Grants Pass, OR 97526-1038
Phone (541) 507-0684

3737 Shasta Way
Suite a
Klamath Falls, OR 97603-4982
Phone (541) 640-7625

4040 W 11TH Ave
Suite B
Eugene, OR 97402-5601
Phone (541) 500-2500

598 E 13TH Ave
Eugene, OR 97401-4783
Phone (541) 636-3473

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.12204-NPOHMDFamily Nurse Practitioner
201501648NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford Health Center, LLC CurrentSince Nov 1, 2010 Accepting new patients
Icco, LLC Current Accepting new patients
Icco LLC CurrentSince Jun 12, 2023 Accepting new patients
Northwest Family Practice LLC Past Accepting new patients

Locations

1820 E Mansfield St
Bucyrus, OH 44820
Phone (419) 562-1413

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611

1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

Interoperability endpoints

  • Direct secure messaging: susanalbright@acmgllc.allscriptsdirect.net

Organizations & group practices 4

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 1

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": "1297987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1265739742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD OFC",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 UNION AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275543",
            "telephone_number": "541-507-2170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1890 NW 6th St",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975261038",
            "country_code": "US",
            "telephone_number": "541-507-0684",
            "fax_number": "541-507-0685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALBRIGHT",
        "first_name": "SUSAN",
        "middle_name": "LARA",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-18",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.12204-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201501648NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500686240",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.