Individual provider Active NPI

Susan M. Seibold-Simpson, FNP

  • Family Nurse Practitioner
  • Vestal, NY
National Provider Identifier
1427175223
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
361513 Issued in NY
Practice address
149 Vestal Pkwy W
Vestal, NY 13850-1543
Phone
(607) 785-4171
NPI assigned
Mar 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 361513 NY Primary

Addresses

Primary practice location

149 Vestal Pkwy W
Vestal, NY 13850-1543

Mailing address

188 Leekville Rd
Glen Aubrey, NY 13777-1110
Phone (607) 862-9322

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
361513NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Planning of South Central New York, Inc. Past Accepting new patients
Southern Tier Women's Health Services LLC PastSince Jun 14, 2019 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6285/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427175223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 LEEKVILLE RD",
            "city": "GLEN AUBREY",
            "state": "NY",
            "postal_code": "137771110",
            "telephone_number": "607-862-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 VESTAL PKWY W",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501543",
            "telephone_number": "607-785-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIBOLD-SIMPSON",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "361513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.