Individual provider Active NPI

Susan Elizabeth Little Jones, MD

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1366530941
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
SL073954 Issued in MI
Practice address
21540 W 11 Mile Rd Ste 200
Southfield, MI 48076-3843
Phone
(248) 352-2000
Fax
(248) 352-8800
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X SL073954 MI
Internal Medicine Physician 207R00000X SL073954 MI Primary

Addresses

Primary practice location

21540 W 11 Mile Rd Ste 200
Southfield, MI 48076-3843

Mailing address

21540 W 11 Mile Rd Ste 200
Southfield, MI 48076-3843
Phone (248) 352-2000

Other practice location 1

75 Barclay Cir
Suite 120
Rochester Hills, MI 48307-5820
Phone (248) 844-0315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040629001105 MI Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Pediatric Medicine 9931185931 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SL073954MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Pediatrics Current Accepting new patients
Vpa PC Internal Medicine CurrentSince Apr 23, 2018 Accepting new patients
Vpa PC Internal Medicine CurrentSince Apr 23, 2018 Accepting new patients

Locations

2725 Airview Blvd
Ste 105
Portage, MI 49002
Phone (269) 349-8386

21540 W 11 Mile Rd
Ste 200
Southfield, MI 48076
Phone (248) 352-2000

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

500 Kirts Blvd
Troy, MI 48084
Phone (214) 824-6000

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

Interoperability endpoints

  • Direct secure messaging: susan.little-jones.1@33201.direct.athenahealth.com

Organizations & group practices 3

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1366530941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21540 W 11 MILE RD STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763843",
            "telephone_number": "248-352-2000",
            "fax_number": "248-352-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21540 W 11 MILE RD STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763843",
            "telephone_number": "248-352-2000",
            "fax_number": "248-352-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Barclay Cir",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Rochester Hills",
            "state": "MI",
            "postal_code": "483075820",
            "country_code": "US",
            "telephone_number": "248-844-0315",
            "fax_number": "248-844-0320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LITTLE JONES",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "SL073954",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "SL073954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.