Individual provider Active NPI

Susan L Duncan, NP

  • Adult Health Nurse Practitioner
  • Summit, MS
National Provider Identifier
1407834732
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN087544-AP05778 Issued in LA
Practice address
7900 Ms-570
Summit, MS 39666
Phone
(601) 684-7771
NPI assigned
Jan 6, 2006
Last updated
Jul 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN11580 TN
Adult Health Nurse Practitioner 363LA2200X RN087544-AP05778 LA Primary
Adult Health Nurse Practitioner 363LA2200X APN0000011580 TN

Addresses

Primary practice location

7900 Ms-570
Summit, MS 39666

Mailing address

423 Lakeview Ave
McComb, MS 39648-2807
Phone (225) 289-1167

Other identifiers 2

IdentifierTypeStateIssuer
3B019D628OtherLAMEDICARE
1883867MedicaidLA

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN11580TNMDNurse Practitioner
RN087544-AP05778LAMDAdult Health Nurse Practitioner
APN0000011580TNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Medicine Institute PC PastSince Sep 23, 2012 Accepting new patients
Advanced Medical Group Adult Health Past Accepting new patients
Advanced Medical Group, P.C. Past Accepting new patients
Pain Consultants of East Tennessee, PLLC PastSince Aug 24, 1998 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1407834732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 LAKEVIEW AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482807",
            "telephone_number": "225-289-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 MS-570",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "39666",
            "telephone_number": "601-684-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "SUSAN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN11580",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "RN087544-AP05778",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "APN0000011580",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "3B019D628",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883867",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.