Individual provider Active NPI

Susana Myung, M.D.

  • Nephrology Physician
  • Cottonwood, AZ
National Provider Identifier
1649215617
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35425 Issued in AZ
Practice address
269 S Candy LN
Cottonwood, AZ 86326-4158
Phone
(928) 639-5588
Fax
(928) 639-5589
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35425 AZ Primary

Addresses

Primary practice location

269 S Candy LN
Cottonwood, AZ 86326-4158

Mailing address

1200 N Beaver St
Payer Credentialing
Flagstaff, AZ 86001-3118
Phone (928) 773-2559

Other identifiers 1

IdentifierTypeStateIssuer
145483MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Oct 14, 2019 Accepting new patients
Avera McKennan Current Accepting new patients
Billings Clinic CurrentSince Aug 4, 2022 Accepting new patients
Billings Clinic Family Medicine CurrentSince Aug 4, 2022 Accepting new patients
Avera McKennan Nephrology CurrentSince Oct 14, 2019 Accepting new patients
Cogent Healthcare of Arizona PC Internal Medicine CurrentSince Aug 1, 2015 Accepting new patients
Akdhc, LLC Nephrology Past Accepting new patients
Northwest Tucson Dialysis LLC Past Accepting new patients
City of Hope Medical Group of Arizona LLC Internal Medicine PastSince Nov 1, 2008 Accepting new patients
Akdhc, LLC Nephrology Past Accepting new patients

Locations

2000 W Bethany Home Rd
Phoenix, AZ 85015
Phone (480) 209-4000

16640 N 38th St
Phoenix, AZ 85032
Phone (602) 482-6671

9003 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 323-3383

801 N 29th St
Billings, MT 59101
Phone (406) 238-2210

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1649215617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "address_2": "PAYER CREDENTIALING",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-773-2559",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 S CANDY LN",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264158",
            "telephone_number": "928-639-5588",
            "fax_number": "928-639-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYUNG",
        "first_name": "SUSANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "35425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145483",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.