Active NPI
Suzanne Rae Salem, NP
- Psychiatric/Mental Health Nurse Practitioner
- Cottonwood, AZ
National Provider Identifier
1467472829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- RN034491
- Practice address
- 601 W Mingus Ave
Cottonwood, AZ 86326 - Phone
- (928) 649-3805
- Fax
- (928) 649-5843
- NPI assigned
- Jul 20, 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN034491 | AZ | Primary |
Addresses
Primary practice location
601 W Mingus Ave
Cottonwood, AZ 86326
Mailing address
4801 W Echo Lane
Glendale, AZ 85302
Phone (602) 292-4997
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 433871 | Medicaid | AZ |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN034491 | AZ | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196899200000",
"number": "1467472829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 W ECHO LANE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85302",
"telephone_number": "602-292-4997",
"fax_number": "623-939-4849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W MINGUS AVE",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "86326",
"telephone_number": "928-649-3805",
"fax_number": "928-649-5843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALEM",
"first_name": "SUZANNE",
"middle_name": "RAE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2007-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "AZ",
"license": "RN034491",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "433871",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cottonwood, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.