Individual provider Active NPI

Susan Glennette Bates, R.N., FIRST ASSIST

  • Registered Nurse
  • Clovis, CA
National Provider Identifier
1366609018
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
358165 Issued in CA
Practice address
26004 Whispering Oak LN
Clovis, CA 93619-9671
Phone
(559) 325-6776
NPI assigned
May 20, 2008
Last updated
May 20, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 358165 CA Primary
Registered Nurse First Assistant 163WR0006X 358165 CA

Addresses

Primary practice location

26004 Whispering Oak LN
Clovis, CA 93619-9671

Mailing address

26004 Whispering Oak LN
Clovis, CA 93619-9671
Phone (559) 325-6776

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
358165CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1366609018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26004 WHISPERING OAK LN",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936199671",
            "telephone_number": "559-325-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26004 WHISPERING OAK LN",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936199671",
            "telephone_number": "559-325-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "SUSAN",
        "middle_name": "GLENNETTE",
        "name_prefix": "Ms.",
        "credential": "R.N., FIRST ASSIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "358165",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "CA",
            "license": "358165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.