Susan Sansom, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

54528 Issued in ID

Practice address

360 E Montvue Dr Ste 100
Meridian, ID 83642-6318

Phone

(208) 855-2900

Fax

(208) 855-2911

NPI assigned

Oct 27, 2016

Last updated

Oct 27, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Onepeak Medical Care LLCGroup PAC ID 1052853264, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCJDDD/Endpoint/CCJDDD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Primary Peak LLC

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1811750458
  Medicare reassignment Care Compare group NPD
• Advanced Family Medicine PLLC

  • Family Medicine Physician
  • Kuna, ID
  • NPI 1598822231
  Medicare reassignment NPD
• Exodus Pain Clinic

  • Interventional Pain Medicine Physician
  • Boise, ID
  • NPI 1366849572
  Medicare reassignment NPD
• Gary Gregerson, M.D., P.a.

  dba Advanced Specialty Care For Women

  • Obstetrics & Gynecology Physician
  • Nampa, ID
  • NPI 1255762506
  Medicare reassignment NPD
• Kuna Healthcare Clinic, PLLC

  • Nurse Practitioner
  • Kuna, ID
  • NPI 1114489788
  NPD
• Energetic Chiropractic PC

  • Chiropractor
  • Boise, ID
  • NPI 1417040031
  NPD (past)
• Gary Gregerson MD PA

  dba Advanced Specialty Care for Women

  • Obstetrics & Gynecology Physician
  • Nampa, ID
  • NPI 1902179914
  NPD (past)
• Jones Foot & Ankle LLC

  • Foot & Ankle Surgery Podiatrist
  • Hailey, ID
  • NPI 1528837374
  NPD (past)
• Richard Radnovich DO PC

  • Sports Medicine (Family Medicine) Physician
  • Boise, ID
  • NPI 1417143926
  NPD (past)

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1538611397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E MONTVUE DR STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426318",
            "telephone_number": "208-855-2900",
            "fax_number": "208-855-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E MONTVUE DR STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426318",
            "telephone_number": "208-855-2900",
            "fax_number": "208-855-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSOM",
        "first_name": "SUSAN",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "54528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Mariah Sanders, LPC MASTERS INTERN
• Rosa Sandoval Alanis, LMSW
• Kelsey Sandoval, PA-C
• Jason Sandy, PHARM.D.
• Jason Sangray, PTA
• Nikki Ryan Santiago
• Kara N Saperston, MD
• Sara Hoyt Consulting
• Matthew Robert Sara, M.D.
• Jocelyn Sarkaria, DO

• Nurse Practitioner in Meridian, ID
• Providers in Meridian, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.