Susan Kay Van Nevel, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 9105988 Issued in FL

Practice address

307 Boatner Rd
Eglin Afb, FL 32542-1302

Phone

(850) 883-9014

NPI assigned

Sep 15, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Susan Kay Rusche Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Baptist Physician Enterprise LLC

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1477860245
  NPD (past)

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1356590392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2385 ABACO DR",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325662558",
            "telephone_number": "850-499-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NEVEL",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1197",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9105988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "RUSCHE",
            "middle_name": "KAY",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Usv Optical Inc.
• James Philip Van Decar, M.D.
• Lauren M Van Decar, M.D.
• Tama Van Decar, M.D.
• Amy Van Lenten, LCSW
• Scott Vandehoef, M.D.
• Dexter Eli Vanderpool, IDMT
• David Alexander Vargas, IDMT
• Jennifer Brown Vaughn, MS, RDN
• Sukran Aykul Velez, BSPHARM, M.S.

• Physician Assistant in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.