Individual provider Active NPI

Susan Kay Block, N.P.

  • Women's Health Nurse Practitioner
  • Fort Walton Beach, FL
National Provider Identifier
1346200417
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
APRN9245884 Issued in FL
Practice address
320 Racetrack Rd NW Ste 100a
Fort Walton Beach, FL 32547-1796
Phone
(850) 315-8360
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 102510 CO
Women's Health Nurse Practitioner 363LW0102X APRN9245884 FL Primary

Addresses

Primary practice location

320 Racetrack Rd NW Ste 100a
Fort Walton Beach, FL 32547-1796

Mailing address

320 Racetrack Rd NW Ste 100a
Fort Walton Beach, FL 32547-1796
Phone (850) 315-8360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1094AKMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Women'S Clinic, LLC PastSince May 2, 2011 Accepting new patients
Obhg Alaska, P.C. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1346200417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 RACETRACK RD NW STE 100A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471796",
            "telephone_number": "850-315-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 RACETRACK RD NW STE 100A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471796",
            "telephone_number": "850-315-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CO",
            "license": "102510",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "APRN9245884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.