Individual provider Active NPI

Susan Parker, CRNP

  • Nurse Practitioner
  • Henagar, AL
National Provider Identifier
1376508218
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1052657 Issued in AL
Practice address
18324 Alabama Highway 75
Henagar, AL 35978
Phone
(256) 657-1101
Fax
(256) 657-1115
NPI assigned
Apr 20, 2006
Last updated
Apr 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1052657 AL Primary

Addresses

Primary practice location

18324 Alabama Highway 75
Henagar, AL 35978

Mailing address

PO Box 518
18324 Al Hwy 75
Henagar, AL 35978-0518
Phone (256) 657-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20040419000444 AL Practitioner - Nurse Practitioner 4587659511 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dekalb Primary CareGroup PAC ID 3274071915, 8 clinicians

Practice addresses (Care Compare)

18324 Broad St
Henagar, AL 35978-4375
Phone (256) 657-1101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1052657ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Payne Clinic Corp CurrentSince Oct 15, 2023 Accepting new patients
Fort Payne Clinic Corp. CurrentSince Oct 15, 2023 Accepting new patients
Dekalb Primary Care CurrentSince Jun 30, 2024 Accepting new patients
Inphynet Contracting Services LLC Nurse Practitioner Past Accepting new patients
Fort Payne RHC Corp Nurse Practitioner Past Accepting new patients
Paragon Contracting Services LLC Nurse Practitioner Past Accepting new patients

Locations

200 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-3150

315 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-0345

18324 Broad St
Henagar, AL 35978
Phone (256) 657-1101

83 George Wallace Dr W
Rainsville, AL 35986
Phone (256) 638-1181

Interoperability endpoints

  • Direct secure messaging: susan.parker.1@30893.direct.athenahealth.com

Organizations & group practices 6

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 2

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1376508218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "address_2": "18324 AL HWY 75",
            "city": "HENAGAR",
            "state": "AL",
            "postal_code": "359780518",
            "telephone_number": "256-657-1101",
            "fax_number": "256-657-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18324 ALABAMA HIGHWAY 75",
            "city": "HENAGAR",
            "state": "AL",
            "postal_code": "35978",
            "telephone_number": "256-657-1101",
            "fax_number": "256-657-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1052657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henagar, AL

Sources for this page

Verify at the official NPI Registry.