Active NPI
Susan Iwasa, RN, CDE
- Diabetes Educator Registered Nurse
- Boise, ID
National Provider Identifier
1487773156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- N-15513
- Practice address
- 1226 W River St
Boise, ID 83702-7049 - Phone
- (208) 331-1155
- Fax
- (208) 383-0190
- NPI assigned
- Mar 27, 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 |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | N-15513 | ID | Primary |
Addresses
Primary practice location
1226 W River St
Boise, ID 83702-7049
Mailing address
253 W Main St
Weiser, ID 83672-1835
Phone (208) 884-0048
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N-15513 | ID | MD | Diabetes Educator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487773156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "253 W MAIN ST",
"city": "WEISER",
"state": "ID",
"postal_code": "836721835",
"telephone_number": "208-884-0048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1226 W RIVER ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837027049",
"telephone_number": "208-331-1155",
"fax_number": "208-383-0190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IWASA",
"first_name": "SUSAN",
"credential": "RN, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "ID",
"license": "N-15513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
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.