Active NPI
Susan M Harrell, MD
- Neonatal-Perinatal Medicine Physician
- Des Moines, IA
National Provider Identifier
1316925837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 30445
- Practice address
- 1200 Pleasant St
Neonatology
Des Moines, IA 50309-1406 - Phone
- (515) 241-5926
- Fax
- (515) 241-5127
- NPI assigned
- Jan 4, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 30445 | IA | Primary |
Addresses
Primary practice location
1200 Pleasant St
Neonatology
Des Moines, IA 50309-1406
Mailing address
1200 Pleasant St
Neonatology
Des Moines, IA 50309-1406
Phone (515) 241-5926
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0123471 | Medicaid | IA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30445 | IA | MD | Neonatal-Perinatal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207008000000",
"number": "1316925837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 PLEASANT ST",
"address_2": "NEONATOLOGY",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091406",
"telephone_number": "515-241-5926",
"fax_number": "515-241-5127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 PLEASANT ST",
"address_2": "NEONATOLOGY",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091406",
"telephone_number": "515-241-5926",
"fax_number": "515-241-5127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "SUSAN",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-04",
"last_updated": "2008-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "IA",
"license": "30445",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0123471",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.