Individual provider Active NPI

Susan Plissey, APRN-CNP

  • Family Nurse Practitioner
  • Patten, ME
National Provider Identifier
1629804935
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP241598 Issued in ME
Practice address
30 Houlton St
Patten, ME 04765-3035
Phone
(207) 538-3700
Fax
(207) 528-2880
NPI assigned
Sep 12, 2024
Last updated
Oct 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP241598 ME Primary
Registered Nurse 163W00000X RN54810 ME

Addresses

Primary practice location

30 Houlton St
Patten, ME 04765-3035

Mailing address

529 S Patten Rd
Patten, ME 04765-3007
Phone (207) 538-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111001018 ME Practitioner - Nurse Practitioner 7416481676 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN54810MEMDRegistered Nurse
CNP241598MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Katahdin Valley Health Center Current Accepting new patients
Katahdin Valley Health Center CurrentSince Oct 14, 2024 Accepting new patients
Katahdin Valley Health Center CurrentSince Oct 14, 2024 Accepting new patients

Locations

59 Bangor St
Houlton, ME 04730
Phone (207) 532-7161

30 Houlton St
Patten, ME 04765
Phone (866) 366-5842

529 S Patten Rd
Patten, ME 04765

Interoperability endpoints

  • Direct secure messaging: susan.plissey.1@7377.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1629804935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 S PATTEN RD",
            "city": "PATTEN",
            "state": "ME",
            "postal_code": "047653007",
            "telephone_number": "207-538-3700",
            "fax_number": "207-528-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HOULTON ST",
            "city": "PATTEN",
            "state": "ME",
            "postal_code": "047653035",
            "telephone_number": "207-538-3700",
            "fax_number": "207-528-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLISSEY",
        "first_name": "SUSAN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP241598",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "RN54810",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patten, ME

Sources for this page

Verify at the official NPI Registry.