Active NPI
Susan Wolffe
- General Practice Registered Nurse
- Teec Nos Pos, AZ
National Provider Identifier
1588060842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- R66812
- Practice address
- JCT US Hwy 160 & Navajo Route 35
Teec Nos Pos, AZ 86514 - Phone
- (928) 656-5163
- Fax
- (928) 656-5164
- NPI assigned
- Nov 14, 2014
- Last updated
- Nov 17, 2014
- 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 |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | R66812 | NM | Primary |
Addresses
Primary practice location
JCT US Hwy 160 & Navajo Route 35
Teec Nos Pos, AZ 86514
Mailing address
HC 61 Box 30
Teec Nos Pos, AZ 86514
Phone (928) 656-5163
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 |
|---|---|---|---|
| R66812 | NM | MD | General Practice Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS PHS Naihs Shiprock Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Four Corners Regional Health Center
- Durable Medical Equipment & Medical Supplies
- Teec Nos Pos, AZ
- NPI 1215083951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416182400000",
"number": "1588060842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 61 BOX 30",
"city": "TEEC NOS POS",
"state": "AZ",
"postal_code": "86514",
"telephone_number": "928-656-5163",
"fax_number": "928-656-5164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JCT US HWY 160 & NAVAJO ROUTE 35",
"city": "TEEC NOS POS",
"state": "AZ",
"postal_code": "86514",
"telephone_number": "928-656-5163",
"fax_number": "928-656-5164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFFE",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-14",
"last_updated": "2014-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "NM",
"license": "R66812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Teec Nos Pos, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.