Individual provider Active NPI

Susan Irick, NP

  • Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1407891518
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN064849 Issued in GA
Practice address
1475 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3806
Phone
(678) 430-3110
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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 RN064849 GA Primary

Addresses

Primary practice location

1475 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3806

Mailing address

1475 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3806
Phone (678) 430-3110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050308000232 GA Practitioner - Nurse Practitioner 2062466691 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appalachian Hospice LLCGroup PAC ID 2567846199, 5 clinicians

Practice addresses (Care Compare)

Cleveland, GA 30528
Phone (706) 865-4241

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Clinic of North Georgia PC CurrentSince Mar 1, 2020 Accepting new patients
Georgia Emergency Department Services, P.C. PastSince Aug 6, 2019 Accepting new patients

Locations

5670 Old Winder Hwy
Ste 200
Braselton, GA 30517
Phone (404) 593-0090

1475 Jesse Jewell Pkwy NE
#300
Gainesville, GA 30501
Phone (678) 825-3685

1287 Sims St
Gainesville, GA 30501
Phone (855) 462-8264

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

317 Resource Pkwy
Winder, GA 30680

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFEHBA

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1407891518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 JESSE JEWELL PKWY NE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806",
            "telephone_number": "678-430-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 JESSE JEWELL PKWY NE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806",
            "telephone_number": "678-430-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRICK",
        "first_name": "SUSAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN064849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.