Active NPI
Susan Boss Chilukuri, C.P.N.P.
- Pediatric Nurse Practitioner
- Missouri City, TX
National Provider Identifier
1508062001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 678410
- Practice address
- 5819 Highway 6
Missouri City, TX 77459-4052 - Phone
- (281) 499-6300
- NPI assigned
- Jun 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 678410 | TX | Primary |
Addresses
Primary practice location
5819 Highway 6
Missouri City, TX 77459-4052
Mailing address
137 Phanturn LN
Bellaire, TX 77401-2607
Phone (713) 385-5286
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 678410 | Other | TX | PNP LICENSE |
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
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 678410 | TX | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200268800000",
"number": "1508062001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 PHANTURN LN",
"city": "BELLAIRE",
"state": "TX",
"postal_code": "774012607",
"telephone_number": "713-385-5286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5819 HIGHWAY 6",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774594052",
"telephone_number": "281-499-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILUKURI",
"first_name": "SUSAN",
"middle_name": "BOSS",
"name_prefix": "Ms.",
"credential": "C.P.N.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-22",
"last_updated": "2008-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TX",
"license": "678410",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PNP LICENSE",
"identifier": "678410",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missouri City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.