Susan Hart, PMHNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

000029202N1 Issued in OR

Practice address

62168 OB Riley Rd E2-16
Bend, OR 97701

Phone

(541) 389-8714

NPI assigned

Jun 9, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Paulina Peak Family Healthcare Inc

  • Family Nurse Practitioner
  • La Pine, OR
  • NPI 1184784332
  NPD (past)

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1376863613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62168 OB RILEY RD E2-16",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-389-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62168 OB RILEY RD E2-16",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-389-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "SUSAN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "000029202N6",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "000029202N1",
            "primary": true
        },
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "OR",
            "license": "000029202N2",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON LICENSE",
            "identifier": "000029202N6",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Harris, L.M.T
• Eric Harry, MD
• Emilie M Hart-Hutter
• David Arthur Hart, MD
• Olivia Rose Hart, MD, MPH
• Jill Marie Hartley, PA-C
• Ursula S Hartman, LPC
• Megan Rae Hartsell, NP
• Kelly Hartsock, M.S. CCC-SLP
• Laurel Hickok Hartwell, M.D.

• Family Nurse Practitioner in Bend, OR
• Providers in Bend, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.