Individual provider Active NPI

Susan Nolan, PA-C

  • Medical Physician Assistant
  • Gallatin, TN
National Provider Identifier
1639479264
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2671 Issued in FL
Practice address
1156 Nashville Pike
Gallatin, TN 37066-3110
Phone
(615) 989-1088
NPI assigned
Oct 29, 2010
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA2671 FL Primary
Medical Physician Assistant 363AM0700X 4724 TN

Addresses

Primary practice location

1156 Nashville Pike
Gallatin, TN 37066-3110

Mailing address

5150 Coldstream LN
Naples, FL 34104-4736
Phone (239) 273-4967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140122001485 FL Practitioner - Physician Assistant 7012145964 Reassigns benefits to 2 organizations
I20241118002790 TN Practitioner - Physician Assistant 7012145964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anova Medical Associates, PLCGroup PAC ID 8325372741, 130 clinicians

Practice addresses (Care Compare)

1156 Nashville Pike
Gallatin, TN 37066-3110
Phone (615) 989-1088

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.25 of 100Reported as apm
Quality
87.73
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4724TNMDClinical Social Worker
PA2671FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd, Inc CurrentSince Jun 21, 2022 Accepting new patients
Millennium Physician Group LLC CurrentSince Jan 2, 2014 Accepting new patients
Nchmd Inc CurrentSince Jun 21, 2022 Accepting new patients

Locations

11181 Health Park Blvd
Ste 2220
Naples, FL 34110
Phone (239) 591-1111

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

681 Goodlette Rd
Ste 130
Naples, FL 34102
Phone (239) 643-9767

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: snolan23118@nchhealthcaresystem.direct-ci.com
  • Direct secure messaging: snolan895685@direct.vumc.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1639479264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 COLDSTREAM LN",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341044736",
            "telephone_number": "239-273-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 NASHVILLE PIKE",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663110",
            "telephone_number": "615-989-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "SUSAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-29",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA2671",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "4724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

Verify at the official NPI Registry.