Susan Renee Harris, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Arlington, VA
NPI 1366614869 · NPPES record last updated Sep 9, 2025
Key facts
- NPI
- 1366614869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024167677 (VA)
- Practice address
- 1101 Wilson Blvd FL 6
Arlington, VA 22209-2281 - Phone
- (888) 731-8994
- NPI assigned
- Mar 25, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Clinch Professional Physician Services LLC
Practice addresses (Care Compare)
111 Fashion Rd
Suite D
Pounding Mill, VA 24637-1200
Phone (276) 596-6375
Hospital & facility affiliations
- Clinch Valley Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081201000720 | VA | Practitioner - Nurse Practitioner | 5193886729 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinch Professional Physician Services LLC | Current |
Accepting new patients | |
| Clinch Professional Physician Services LLC | Current |
Accepting new patients | |
| Cancer Outreach Associates, P.C. | Past | Accepting new patients | |
| Clinch Valley Urology, LLC | Past | Accepting new patients | |
| Virginia Oncology Care, P.C. | Past | Accepting new patients |
Locations
1100 Cedar Valley Dr
Ste 3
Cedar Bluff, VA 24609
Phone (276) 596-6449
1100 Cedar Valley Dr
Cedar Bluff, VA 24609
Phone (276) 596-9551
111 Fashion Rd
Ste D
Pounding Mill, VA 24637
Phone (276) 325-0461
111 Fashion Rd
Pounding Mill, VA 24637
6719 Governor Gc Peery Hwy
Ste 2450
Richlands, VA 24641
Phone (276) 596-6786
Interoperability endpoints
- susan.harris.1@19847.direct.athenahealth.com
- susan.harris@vab.hcadirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024167677 | VA | Yes |
Addresses
Primary practice location
1101 Wilson Blvd FL 6
Arlington, VA 22209-2281
Mailing address
109 Shale St
Richlands, VA 24641-2926
Phone (276) 971-1030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0024167677 | Other | VA | VA LICENSE |
Other providers in Arlington, VA
- Harris Teeter, LLC
- Harris Teeter, LLC
- Dana Nicole Harris
- Johnel Harris
- Lindsey Harris
- Ashley Harrison
- Emily Jessica Hart
- Jacquelyn Renee Hart
- Alyssa Hartman
- Kate-Alden G. Hartman
All providers in Arlington, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.