Susan Beardsley Seckinger, R. N.

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP018052 Issued in PA

Practice address

1930 S Broad St
Philadelphia, PA 19145-2328

Phone

(215) 339-4563

NPI assigned

Nov 15, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

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.

• Advanced Vascular and Wound Associates Inc

  • Internal Medicine Physician
  • Darby, PA
  • NPI 1205376381
  NPD (past)

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1467796300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 N COLUMBUS BLVD",
            "address_2": "PIER 5 UNIT 134",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191061422",
            "telephone_number": "267-825-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452328",
            "telephone_number": "215-339-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECKINGER",
        "first_name": "SUSAN",
        "middle_name": "BEARDSLEY",
        "name_prefix": "Ms.",
        "credential": "R. N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN291146L",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP018052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephy Sebastian
• Christopher Sebastiano, M.D.
• Stacy Sebro, MS, LPC
• Michael Sechuk
• Jessica Seck, DPT
• Second Hand Home Care LLC
• William Secor, DO
• Secure Labs LLC
• Secure Labs LLC
• Daisy Seda

• Gerontology Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.