Active NPI
Susan Macie Vazquez, MSN, RN, APRN, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Orlando, FL
National Provider Identifier
1346012937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 11029294
- Practice address
- 255 S Orange Ave Ste 104
Orlando, FL 32801-3411 - Phone
- (407) 720-5900
- NPI assigned
- Oct 26, 2023
- Last updated
- Apr 12, 2024
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 11029294 | FL | Primary |
Addresses
Primary practice location
255 S Orange Ave Ste 104
Orlando, FL 32801-3411
Mailing address
255 S Orange Ave Ste 104
Orlando, FL 32801-3411
Other names 1
- Susan Macie Keenan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11029294 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CH MH Services (Oh), LLC | Past | Accepting new patients |
Interoperability endpoints
- susan.vazquez@489656322949124.direct.elationemr.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Adolescent and Children Mental Health Clinic/Center
- Columbus, OH
- NPI 1457006744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712880000000",
"number": "1346012937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 S ORANGE AVE STE 104",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328013411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 S ORANGE AVE STE 104",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328013411",
"telephone_number": "407-720-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAZQUEZ",
"first_name": "SUSAN",
"middle_name": "MACIE",
"credential": "MSN, RN, APRN, PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-26",
"last_updated": "2024-04-12",
"certification_date": "2024-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "FL",
"license": "11029294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "KEENAN",
"middle_name": "MACIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.