Individual provider Active NPI

Susan McBride Koff, A.R.N.P.

  • Gerontology Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1609840875
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
3100483 Issued in FL
Practice address
5300 East Ave
West Palm Beach, FL 33407-2387
Phone
(561) 227-5270
Fax
(561) 863-2803
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 3100483 FL Primary

Addresses

Primary practice location

5300 East Ave
West Palm Beach, FL 33407-2387

Mailing address

5300 East Ave
West Palm Beach, FL 33407-2387
Phone (561) 227-5270

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

State licenses

LicenseStateTypeSpecialty
3100483FLMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1609840875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 EAST AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072387",
            "telephone_number": "561-227-5270",
            "fax_number": "561-863-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 EAST AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072387",
            "telephone_number": "561-227-5270",
            "fax_number": "561-863-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFF",
        "first_name": "SUSAN",
        "middle_name": "MCBRIDE",
        "name_prefix": "Ms.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "3100483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.