Individual provider Active NPI

Susan Lynne Farber, MD

  • Pediatrics Physician
  • Minot AFB, ND
National Provider Identifier
1366424780
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD0000030948 Issued in TN
Practice address
10 Missle Ave
Minot AFB, ND 58705-5003
Phone
(701) 723-5454
Fax
(701) 723-5769
NPI assigned
Nov 20, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD0000030948 TN Primary

Addresses

Primary practice location

10 Missle Ave
Minot AFB, ND 58705-5003

Mailing address

164 Delta Dr
Minot AFB, ND 58704-1301
Phone (701) 727-6904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000030948TNMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1132444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366424780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 DELTA DR",
            "city": "MINOT AFB",
            "state": "ND",
            "postal_code": "587041301",
            "telephone_number": "701-727-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MISSLE AVE",
            "city": "MINOT AFB",
            "state": "ND",
            "postal_code": "587055003",
            "telephone_number": "701-723-5454",
            "fax_number": "701-723-5769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARBER",
        "first_name": "SUSAN",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD0000030948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot AFB, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.