Susan Ann Huber-Bartlett, PA-C

Key facts

NPI

1407948532

Entity type

Individual (NPI type 1)

Primary specialty

Physician Assistant 363A00000X

License

085001067 (IL)

Practice address

225 S Congress St
Rushville, IL 62681-1409

Phone

(217) 322-3529

Fax

(217) 322-2065

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 10, 2011.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1407948532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S CONGRESS ST",
            "city": "RUSHVILLE",
            "state": "IL",
            "postal_code": "626811409",
            "telephone_number": "217-322-3529",
            "fax_number": "217-322-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S CONGRESS ST",
            "city": "RUSHVILLE",
            "state": "IL",
            "postal_code": "626811409",
            "telephone_number": "217-322-3529",
            "fax_number": "217-322-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBER-BARTLETT",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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