Individual provider Active NPI

Susanna Draighan, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Providence, RI
National Provider Identifier
1417484254
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN01685 Issued in RI
Practice address
331 Broadway Ste 302
Providence, RI 02909-1101
Phone
(401) 217-9377
Fax
(401) 200-3166
NPI assigned
May 11, 2017
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2327944 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN01685 RI Primary

Addresses

Primary practice location

331 Broadway Ste 302
Providence, RI 02909-1101

Mailing address

331 Broadway Ste 302
Providence, RI 02909-1101
Phone (401) 217-9377

Other practice location 1

460 Pine St
Providence, RI 02907-1358
Phone (401) 272-0220

Other names 1

  • Susanna Draine Former name

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

State licenses

LicenseStateTypeSpecialty
2327944MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Opal Behavioral Health Psychiatric/Mental Health CurrentSince Apr 1, 2023 Accepting new patients
Amos House Past Accepting new patients
Amos House PastSince Apr 25, 2024 Accepting new patients

Locations

383 W Fountain St
Ste 103
Providence, RI 02903
Phone (401) 217-9377

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, 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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1417484254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 BROADWAY STE 302",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029091101",
            "telephone_number": "401-217-9377",
            "fax_number": "401-200-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 BROADWAY STE 302",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029091101",
            "telephone_number": "401-217-9377",
            "fax_number": "401-200-3166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Pine St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029071358",
            "country_code": "US",
            "telephone_number": "401-272-0220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAIGHAN",
        "first_name": "SUSANNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2327944",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN01685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNA",
            "last_name": "DRAINE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.