Individual provider Active NPI

Susan Baby, NP

  • Gerontology Nurse Practitioner
  • Austin, TX
National Provider Identifier
1639544794
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP128480 Issued in TX
Practice address
901 S Mopac Expressway
Building II Suite 130
Austin, TX 78746-5776
Phone
(800) 897-9177
Fax
(800) 470-8713
NPI assigned
Dec 1, 2015
Last updated
Dec 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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 AP128480 TX Primary

Addresses

Primary practice location

901 S Mopac Expressway
Building II Suite 130
Austin, TX 78746-5776

Mailing address

3961 Creekside LN
Carrollton, TX 75010-6398
Phone (972) 762-3033

Other identifiers 1

IdentifierTypeStateIssuer
AP128480OtherTXSTATE LICENSE

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
AP128480TXMDGerontology Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: sbaby295486@direct.phhs.org

NPI Registry JSON

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1639544794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3961 CREEKSIDE LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106398",
            "telephone_number": "972-762-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S MOPAC EXPRESSWAY",
            "address_2": "BUILDING II SUITE 130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787465776",
            "telephone_number": "800-897-9177",
            "fax_number": "800-470-8713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABY",
        "first_name": "SUSAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP128480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AP128480",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.