Active NPI
Susan S Starke, FNP
- Family Nurse Practitioner
- Roseburg, OR
National Provider Identifier
1477583375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Practice address
- 913 NW Garden Valley Blvd
Roseburg, OR 97470-6523 - Phone
- (541) 440-1000
- Fax
- (541) 440-1208
- NPI assigned
- Jul 4, 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | OR | Primary |
Addresses
Primary practice location
913 NW Garden Valley Blvd
Roseburg, OR 97470-6523
Mailing address
1647 NE Commercial Ave
Roseburg, OR 97470-3210
Phone (541) 464-8599
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200250179NP | OR | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477583375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1647 NE COMMERCIAL AVE",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974703210",
"telephone_number": "541-464-8599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "913 NW GARDEN VALLEY BLVD",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974706523",
"telephone_number": "541-440-1000",
"fax_number": "541-440-1208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARKE",
"first_name": "SUSAN",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseburg, OR
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.