Individual provider Active NPI

Susan Renee Harris, FNP-C

  • Family Nurse Practitioner
  • Arlington, VA
National Provider Identifier
1366614869
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024167677 Issued in VA
Practice address
1101 Wilson Blvd FL 6
Arlington, VA 22209-2281
Phone
(888) 731-8994
NPI assigned
Mar 25, 2008
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024167677 VA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081201000720 VA Practitioner - Nurse Practitioner 5193886729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Fashion Rd
Suite D
Pounding Mill, VA 24637-1200
Phone (276) 596-6375

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024167677VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinch Professional Physician Services LLC CurrentSince Jul 1, 2013 Accepting new patients
Clinch Professional Physician Services LLC CurrentSince Jul 1, 2013 Accepting new patients
Virginia Oncology Care, P.C. Past Accepting new patients
Cancer Outreach Associates, P.C. Past Accepting new patients

Locations

1100 Cedar Valley Dr
Cedar Bluff, VA 24609
Phone (276) 596-9551

1100 Cedar Valley Dr
Ste 3
Cedar Bluff, VA 24609
Phone (276) 596-6449

111 Fashion Rd
Pounding Mill, VA 24637

111 Fashion Rd
Ste D
Pounding Mill, VA 24637
Phone (276) 596-6375

6719 Governor Gc Peery Hwy
Ste 2450
Richlands, VA 24641
Phone (276) 596-6786

Interoperability endpoints

  • Direct secure messaging: susan.harris.1@19847.direct.athenahealth.com
  • Direct secure messaging: susan.harris@vab.hcadirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1366614869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 SHALE ST",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246412926",
            "telephone_number": "276-971-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 WILSON BLVD FL 6",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092281",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SUSAN",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-25",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024167677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.