Active NPI
Nina Sussman
- Pharmacist
- Polson, MT
National Provider Identifier
1427525518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 71154
- Practice address
- 36318 Memory LN
Polson, MT 59860-7265 - Phone
- (406) 883-9221
- NPI assigned
- Oct 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P8935 | ID | |
| Pharmacist | 183500000X | 20032 | NV | |
| Pharmacist | 183500000X | 71154 | MT | Primary |
Addresses
Primary practice location
36318 Memory LN
Polson, MT 59860-7265
Mailing address
36248 Turtle Lake Rd
Polson, MT 59860-8166
Phone (406) 529-0235
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
| License | State | Type | Specialty |
|---|---|---|---|
| P8935 | ID | MD | Pharmacist |
| 71154 | MT | MD | Pharmacist |
| 20032 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605916800000",
"number": "1427525518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36248 TURTLE LAKE RD",
"city": "POLSON",
"state": "MT",
"postal_code": "598608166",
"telephone_number": "406-529-0235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36318 MEMORY LN",
"city": "POLSON",
"state": "MT",
"postal_code": "598607265",
"telephone_number": "406-883-9221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUSSMAN",
"first_name": "NINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-27",
"last_updated": "2020-11-21",
"certification_date": "2020-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P8935",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "20032",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "71154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Polson, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.