Active NPI
Susan Shotts, RT (R)
- Diagnostic Radiology Physician
- Gilbert, AZ
National Provider Identifier
1295345783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- CRT18236
- Practice address
- 861 N Higley Rd Ste B101
Gilbert, AZ 85234-9602 - Phone
- (480) 813-9600
- Fax
- (480) 813-9601
- NPI assigned
- Aug 9, 2020
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | CRT18236 | AZ | Primary |
Addresses
Primary practice location
861 N Higley Rd Ste B101
Gilbert, AZ 85234-9602
Mailing address
555 S 107TH St
Mesa, AZ 85208-5703
Phone (484) 272-4239
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CRT18236 | Other | AZ | STATE F AZ LICENSE |
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 |
|---|---|---|---|
| CRT18236 | AZ | MD | Diagnostic Radiology Physician |
Interoperability endpoints
- https://api.platform.athenahealth.com/13750/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596931200000",
"number": "1295345783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 S 107TH ST",
"city": "MESA",
"state": "AZ",
"postal_code": "852085703",
"telephone_number": "484-272-4239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "861 N HIGLEY RD STE B101",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852349602",
"telephone_number": "480-813-9600",
"fax_number": "480-813-9601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOTTS",
"first_name": "SUSAN",
"credential": "RT (R)",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-09",
"last_updated": "2020-08-09",
"certification_date": "2020-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AZ",
"license": "CRT18236",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE F AZ LICENSE",
"identifier": "CRT18236",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.