Individual provider Active NPI

Susan Kay Staples, APRN

  • Family Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1508380478
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3011683 Issued in KY
Practice address
944 Searcy Way
Bowling Green, KY 42103-7168
Phone
(270) 467-7180
Fax
(270) 904-2862
NPI assigned
Aug 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0000855-C-NP CO
Family Nurse Practitioner 363LF0000X 3011683 KY Primary

Addresses

Primary practice location

944 Searcy Way
Bowling Green, KY 42103-7168

Mailing address

944 Searcy Way
Bowling Green, KY 42103-7168
Phone (270) 467-7180

Other identifiers 1

IdentifierTypeStateIssuer
7100475690MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200701000585 NM Practitioner - Nurse Practitioner 2264706860 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hidalgo Medical ServicesGroup PAC ID 4587572250, 33 clinicians

Practice addresses (Care Compare)

1007 N Pope St
HMS Community Health Center
Silver City, NM 88061-5161
Phone (575) 388-1511

1318 E 32ND St
Tranquil Skies Community Mental Health
Silver City, NM 88061-7252
Phone (575) 388-4412

530 De Moss St
Lordsburg, NM 88045-2618
Phone (575) 542-8384

Hospital & facility affiliations

  • Gila Regional Medical Center Hospital, Silver City, NM, CCN 321311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0000855-C-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Health Care PC CurrentSince Sep 8, 2020 Accepting new patients
Hidalgo Medical Services Current Accepting new patients
Hidalgo Medical Services CurrentSince Apr 21, 2023 Accepting new patients
Hidalgo Medical Services CurrentSince Apr 21, 2023 Accepting new patients

Locations

530 De Moss St
Lordsburg, NM 88045
Phone (575) 542-2368

1007 N Pope St
Silver City, NM 88061
Phone (575) 388-1511

1600 E 32nd St
Silver City, NM 88061
Phone (505) 538-2981

1318 E 32nd St
Silver City, NM 88061
Phone (505) 388-1913

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20156/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1508380478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 SEARCY WAY",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037168",
            "telephone_number": "270-467-7180",
            "fax_number": "709-042-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "944 SEARCY WAY",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037168",
            "telephone_number": "270-467-7180",
            "fax_number": "270-904-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0000855-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3011683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100475690",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.