Individual provider Active NPI

Susan D Ford, CRNA

  • Certified Registered Nurse Anesthetist
  • Huntsville, AL
National Provider Identifier
1417975541
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
29909 Issued in TN
Practice address
911 Big Cove Rd SE
Anesthesia Dept
Huntsville, AL 35801-3750
Phone
(256) 265-8120
Fax
(256) 265-8969
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-049597 AL
Certified Registered Nurse Anesthetist 367500000X 29909 TN Primary

Addresses

Primary practice location

911 Big Cove Rd SE
Anesthesia Dept
Huntsville, AL 35801-3750

Mailing address

PO Box 1389
Huntsville, AL 35807-0389
Phone (205) 979-5882

Other identifiers 3

IdentifierTypeStateIssuer
51528052OtherALBCBS #
P00242554OtherALRR MEDICARE #
051528052MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050607001110 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628011988 Reassigns benefits to 2 organizations
I20210806002140 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628011988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntsville Hospital AnesthesiaGroup PAC ID 7315990751, 157 clinicians

Practice addresses (Care Compare)

101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone (256) 265-8120

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5000

9300 Park W Blvd
Knoxville, TN 37923-4301
Phone (865) 546-8040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-049597ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. CurrentSince Aug 2, 2021 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Aug 2, 2021 Accepting new patients
Epix Anesthesia of Alabama LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 18, 2018 Accepting new patients
Huntsville Hospital Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Feb 9, 2019 Accepting new patients
Jacksonville Medical Professional Services LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
QHG of Jacksonville Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
The Health Care Authority of the City of Huntsville Past Accepting new patients

Locations

400 E 10th St
Anniston, AL 36207
Phone (256) 235-5121

201 Governors Dr SW
Huntsville, AL 35801
Phone (256) 265-6851

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

911 Big Cove Rd SE
Huntsville, AL 35801
Phone (256) 265-8120

245 Governors Dr SE
Huntsville, AL 35801
Phone (256) 265-7673

1701 Pelham Rd S
Jacksonville, AL 36265
Phone (256) 435-4970

8375 Highway 72 W
Madison, AL 35758
Phone (256) 265-2012

380 Woods Cove Rd
Scottsboro, AL 35768
Phone (256) 218-3579

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1417975541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1389",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358070389",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 BIG COVE RD SE",
            "address_2": "ANESTHESIA DEPT",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013750",
            "telephone_number": "256-265-8120",
            "fax_number": "256-265-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-049597",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "29909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "51528052",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE #",
            "identifier": "P00242554",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051528052",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.