Individual provider Active NPI

Susan A Muhlbauer, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Carroll, IA
National Provider Identifier
1629029129
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
T074863 Issued in IA
Practice address
311 S Clark St
Carroll, IA 51401-3038
Phone
(712) 792-3581
Fax
(712) 794-1751
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X T074863 IA Primary

Addresses

Primary practice location

311 S Clark St
Carroll, IA 51401-3038

Mailing address

311 S Clark St
Carroll, IA 51401-3038
Phone (712) 792-3581

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidIA

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
T074863IAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1629029129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-3581",
            "fax_number": "712-794-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-3581",
            "fax_number": "712-794-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUHLBAUER",
        "first_name": "SUSAN",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "T074863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.