Susan Jo Ponder, RN, CNS/RXN

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

130627 Issued in CO

Practice address

1919 65TH Ave Ste 3
Greeley, CO 80634-7965

Phone

(970) 590-1138

Fax

(970) 356-7437

NPI assigned

Aug 8, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622419200000",
    "number": "1336496330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 65TH AVENUE, SUITE 3",
            "address_2": "INTEGRATION MENTAL HEALTH",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-590-1138",
            "fax_number": "970-356-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 65TH AVE STE 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347965",
            "telephone_number": "970-590-1138",
            "fax_number": "970-356-7437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8931 Huron St",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802606806",
            "country_code": "US",
            "telephone_number": "970-590-1138",
            "fax_number": "970-356-7437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONDER",
        "first_name": "SUSAN",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "RN, CNS/RXN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2021-05-31",
        "certification_date": "2021-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "CO",
            "license": "130627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134592256",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "1336496330",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Greeley",
            "affiliation": "N",
            "address_1": "1919 65th Ave Ste 3",
            "city": "Greeley",
            "state": "CO",
            "country_code": "US",
            "postal_code": "806347965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Travis Polk, AGACNP-BC
• Eks Wye Pollock IV, MD
• Allison Polzin, AG-ACNP
• Sarah Polzin, MA,LPC
• Susan Marie Pomering, APN
• Surabhi Poola, MD
• Amanda Pope
• Lauren Olivia Poppaw, CRNA
• Jamie Lee Porter, FNP
• Portercare Adventist Health System (AdventHealth Transplant Institute Greeley)

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Greeley, CO
• Providers in Greeley, CO by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.