Individual provider Active NPI

Susan J Little, RPN

  • Pediatric Registered Nurse
  • Ballston Lake, NY
National Provider Identifier
1285815365
Registry record updated Nov 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
360201-1 Issued in NY
Practice address
24 Hunters Run
Ballston Lake, NY 12019-1050
Phone
(518) 899-4232
NPI assigned
Nov 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 360201-1 NY
Neonatal Intensive Care Registered Nurse 163WN0002X 360201-1 NY
Low-Risk Neonatal Registered Nurse 163WN0003X 360201-1 NY
Pediatric Registered Nurse 163WP0200X 360201-1 NY Primary

Addresses

Primary practice location

24 Hunters Run
Ballston Lake, NY 12019-1050

Mailing address

24 Hunters Run
Ballston Lake, NY 12019-1050
Phone (518) 899-4232

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
360201-1NYMDNeonatal Intensive Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1195257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195257600000",
    "number": "1285815365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HUNTERS RUN",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120191050",
            "telephone_number": "518-899-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HUNTERS RUN",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120191050",
            "telephone_number": "518-899-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "SUSAN",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "RPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-17",
        "last_updated": "2007-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "360201-1",
            "primary": false
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "NY",
            "license": "360201-1",
            "primary": false
        },
        {
            "code": "163WN0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal, Low-Risk",
            "state": "NY",
            "license": "360201-1",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "360201-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.