Susan Parker

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

006094 Issued in CT

Practice address

290 Western Blvd
Glastonbury, CT 06033-1236

Phone

(860) 652-5070

NPI assigned

Jun 22, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susan.parker.npi1265814719.phpct@direct.optumcare.masshiway.net

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053
  Medicare reassignment NPD
• South Windsor Pediatrics, LLC

  • Pediatric Adolescent Medicine Physician
  • South Windsor, CT
  • NPI 1851588701
  NPD (past)
• Lswhb LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Milford, OH
  • NPI 1407325939
  NPD (past)

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1265814719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 WESTERN BLVD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331236",
            "telephone_number": "860-652-3325",
            "fax_number": "860-928-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 WESTERN BLVD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331236",
            "telephone_number": "860-652-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "006094",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pavlos K Papasavas, M.D.
• Thona M Pappas, L.C.S.W.
• Lawrence M Pareles, M.D.
• Brienna Krisnah Parenti, PA-C
• Jong-Yun Park, D.D.S.
• Joseph R Paskale, DC
• Sonal Jitendra Patel Maru, DMD
• Nandini Patel
• Nimesh L. Patel, DMD
• Alyssa Lee Patenaude, MS, LMFT

• Family Nurse Practitioner in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.