Individual provider Active NPI

Susan B Kohn, F.N.P.

  • Family Nurse Practitioner
  • Groton, CT
National Provider Identifier
1437284395
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
005447 Issued in CT
Practice address
481 Gold Star Hwy
Suite 100
Groton, CT 06340-6702
Phone
(860) 446-8858
Fax
(860) 405-2140
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0000005975 TN
Ambulatory Care Registered Nurse 163WP2201X 0000067622 TN
Family Nurse Practitioner 363LF0000X 005447 CT Primary

Addresses

Primary practice location

481 Gold Star Hwy
Suite 100
Groton, CT 06340-6702

Mailing address

481 Gold Star Hwy
Suite 100
Groton, CT 06340-6702
Phone (860) 446-8858

Other names 1

  • Susan Bressler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171115001009 TX Practitioner - Nurse Practitioner 4284828195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0000067622TNMDAmbulatory Care Registered Nurse
5975TNMDPhysical Therapist
005447CTMDFamily Nurse Practitioner
0000005975TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation CurrentSince Oct 4, 2017 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Oct 4, 2017 Accepting new patients
Primary Care and Pain Relief Center Dba Nashvillehealth Services, Inc. Past Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1437284395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 GOLD STAR HWY",
            "address_2": "SUITE 100",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406702",
            "telephone_number": "860-446-8858",
            "fax_number": "860-405-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 GOLD STAR HWY",
            "address_2": "SUITE 100",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406702",
            "telephone_number": "860-446-8858",
            "fax_number": "860-405-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHN",
        "first_name": "SUSAN",
        "middle_name": "B",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "0000005975",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "TN",
            "license": "0000067622",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BRESSLER",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Groton, CT

Sources for this page

Verify at the official NPI Registry.