Active NPI
Susan Stogdill
- Diabetes Educator Registered Nurse
- Council Bluffs, IA
National Provider Identifier
1629485008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- 059576
- Practice address
- 800 Mercy Dr
Diabetes Education Dept
Council Bluffs, IA 51503-3128 - Phone
- (712) 325-2543
- NPI assigned
- Jul 17, 2014
- Last updated
- Jul 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 |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | 059576 | IA | Primary |
Addresses
Primary practice location
800 Mercy Dr
Diabetes Education Dept
Council Bluffs, IA 51503-3128
Mailing address
PO Box 642117
Omaha, NE 68164-8117
Phone (712) 325-2543
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 |
|---|---|---|---|
| 059576 | IA | MD | Diabetes Educator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405555200000",
"number": "1629485008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 642117",
"city": "OMAHA",
"state": "NE",
"postal_code": "681648117",
"telephone_number": "712-325-2543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 MERCY DR",
"address_2": "DIABETES EDUCATION DEPT",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515033128",
"telephone_number": "712-325-2543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOGDILL",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-17",
"last_updated": "2014-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "IA",
"license": "059576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.