Active NPI
Susan Rebecca Mills, CPNP
- Pediatric Nurse Practitioner
- La Follette, TN
National Provider Identifier
1437280815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 7425
- Practice address
- 2221 Jacksboro Pike Ste C4
La Follette, TN 37766 - Phone
- (423) 566-3488
- Fax
- (866) 722-3453
- NPI assigned
- Mar 8, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 7425 | TN | Primary |
Addresses
Primary practice location
2221 Jacksboro Pike Ste C4
La Follette, TN 37766
Mailing address
PO Box 15004
Knoxville, TN 37901-5004
Phone (865) 541-8895
Other practice location 1
145 E Vance Rd
Oak Ridge, TN 37830-6528
Phone (865) 482-4088
Other practice location 2
2130 N. Charles Seivers Blvd.
Suite 4
Clinton, TN 37716
Phone (865) 457-4044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q000813 | Medicaid | TN |
Other names 1
- Susan Rebecca McCue
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7425 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1437280815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15004",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379015004",
"telephone_number": "865-541-8895",
"fax_number": "865-633-4808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2221 JACKSBORO PIKE STE C4",
"city": "LA FOLLETTE",
"state": "TN",
"postal_code": "37766",
"telephone_number": "423-566-3488",
"fax_number": "866-722-3453"
}
],
"practiceLocations": [
{
"address_1": "145 E Vance Rd",
"address_purpose": "LOCATION",
"city": "Oak Ridge",
"state": "TN",
"postal_code": "378306528",
"country_code": "US",
"telephone_number": "865-482-4088",
"fax_number": "865-481-0329",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2130 N. Charles Seivers Blvd.",
"address_2": "Suite 4",
"address_purpose": "LOCATION",
"city": "Clinton",
"state": "TN",
"postal_code": "37716",
"country_code": "US",
"telephone_number": "865-457-4044",
"fax_number": "866-699-4833",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLS",
"first_name": "SUSAN",
"middle_name": "REBECCA",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TN",
"license": "7425",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q000813",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "MCCUE",
"middle_name": "REBECCA",
"credential": "CPNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in La Follette, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.