Individual provider Active NPI

Susanne S Drury, PH.D.

  • Clinical Psychologist
  • Phoenix, AZ
National Provider Identifier
1346363207
Registry record updated May 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1802 Issued in AZ
Practice address
2737 E. Greenway Blvd
Phoenix, AZ 85032-4665
Phone
(602) 625-2852
NPI assigned
Apr 7, 2007
Last updated
May 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1802 AZ Primary

Addresses

Primary practice location

2737 E. Greenway Blvd
Phoenix, AZ 85032-4665

Mailing address

3023 E Vista Dr
Phoenix, AZ 85032-4435
Phone (602) 625-2852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180720001840 NM Practitioner - Clinical Psychologist 0042567182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
GD Psych Services, LLCGroup PAC ID 6204260474, 18 clinicians

Practice addresses (Care Compare)

2200 Grande Blvd SE
Suite B
Rio Rancho, NM 87124-1695
Phone (505) 218-6383

2200 Grande Blvd SE B
Rio Rancho, NM 87124-1695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1802AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Families of Albuquerque LLC CurrentSince Jun 6, 2018 Accepting new patients
GD Psych Services, LLC CurrentSince Oct 7, 2019 Accepting new patients

Locations

1803 Carlisle Blvd NE
Albuquerque, NM 87110
Phone (505) 842-9911

2200 Grande Blvd SE
Ste B
Rio Rancho, NM 87124
Phone (505) 218-6383

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.

NPI Registry JSON

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1346363207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 E VISTA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324435",
            "telephone_number": "602-625-2852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 E. GREENWAY BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324665",
            "telephone_number": "602-625-2852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRURY",
        "first_name": "SUSANNE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-07",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "1802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.