Active NPI
Susan B. Brown, NP
- Adult Health Nurse Practitioner
- Portland, ME
National Provider Identifier
1609139526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- CNP121033
- Practice address
- 84 Marginal Way
Suite 700
Portland, ME 04101 - Phone
- (207) 774-5816
- Fax
- (207) 523-8597
- NPI assigned
- Jun 18, 2012
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | CNP121033 | ME | Primary |
Addresses
Primary practice location
84 Marginal Way
Suite 700
Portland, ME 04101
Mailing address
100 Gannett Drive
Suite C
South Portland, ME 04106
Phone (207) 523-3649
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459123200000",
"number": "1609139526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 GANNETT DRIVE",
"address_2": "SUITE C",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "04106",
"telephone_number": "207-523-3649",
"fax_number": "207-874-1483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 MARGINAL WAY",
"address_2": "SUITE 700",
"city": "PORTLAND",
"state": "ME",
"postal_code": "04101",
"telephone_number": "207-774-5816",
"fax_number": "207-523-8597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SUSAN",
"middle_name": "B.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-18",
"last_updated": "2016-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "ME",
"license": "CNP121033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.