Active NPI
Susan D Smith, MSN CPNP
- Pediatrics Physician
- Duluth, GA
National Provider Identifier
1437167939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- RN050646
- Practice address
- 3645 A Howell Ferry Rd
Duluth, GA 30096 - Phone
- (678) 473-4738
- Fax
- (679) 473-4739
- NPI assigned
- Aug 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | RN050646 | GA | Primary |
Addresses
Primary practice location
3645 A Howell Ferry Rd
Duluth, GA 30096
Mailing address
3645 A Howell Ferry Rd
Duluth, GA 30096
Phone (678) 473-4738
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 796001599A | Medicaid | GA |
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
- Credentials
- Certified Pediatric Nurse Practitioner, Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN050646 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cooper Pediatrics | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Duluth, GA
- NPI 1215138524
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437167939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3645 A HOWELL FERRY RD",
"city": "DULUTH",
"state": "GA",
"postal_code": "30096",
"telephone_number": "678-473-4738",
"fax_number": "679-473-4739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3645 A HOWELL FERRY RD",
"city": "DULUTH",
"state": "GA",
"postal_code": "30096",
"telephone_number": "678-473-4738",
"fax_number": "679-473-4739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SUSAN",
"middle_name": "D",
"credential": "MSN CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "RN050646",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "796001599A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
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.