Individual provider Active NPI

Susan Page Oetzel Husband, NP-C

  • Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1285773358
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F0606227 Issued in MS
Practice address
2906 N State St
Ste 301
Jackson, MS 39216-4233
Phone
(601) 982-1001
Fax
(601) 982-1288
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F0606227 MS Primary

Addresses

Primary practice location

2906 N State St
Ste 301
Jackson, MS 39216-4233

Mailing address

PO Box 757
Jackson, MS 39205-0757
Phone (601) 982-1001

Other identifiers 1

IdentifierTypeStateIssuer
F0606227OtherMSCERTIFICATION

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

LicenseStateTypeSpecialty
F0606227MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mitchell Myers, M.D. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285773358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392050757",
            "telephone_number": "601-982-1001",
            "fax_number": "601-982-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 N STATE ST",
            "address_2": "STE 301",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164233",
            "telephone_number": "601-982-1001",
            "fax_number": "601-982-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSBAND",
        "first_name": "SUSAN",
        "middle_name": "PAGE OETZEL",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "F0606227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION",
            "identifier": "F0606227",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

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.

Verify at the official NPI Registry.