Active NPI
Suzanne Tershak Tither, FNP
- Family Nurse Practitioner
- Boston, MA
National Provider Identifier
1659629483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 143721
- Practice address
- 100 Cambridge St FL 14
Boston, MA 02114-2509 - Phone
- (888) 731-8994
- NPI assigned
- Aug 28, 2012
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024170298 | VA | |
| Family Nurse Practitioner | 363LF0000X | 201709803NP-PP | OR | |
| Family Nurse Practitioner | 363LF0000X | 4704369510 | MI | |
| Family Nurse Practitioner | 363LF0000X | RN267597 | MA | |
| Family Nurse Practitioner | 363LF0000X | 143721 | MT | Primary |
Addresses
Primary practice location
100 Cambridge St FL 14
Boston, MA 02114-2509
Mailing address
4 Fraker Loop
Whitehall, MT 59759-8695
Phone (443) 223-9252
Other practice location 1
111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone (443) 223-9252
Other practice location 2
3010 Santa Fe Ct Fl 1
Missoula, MT 59808-1730
Phone (888) 731-8994
Other practice location 3
1101 Wilson Blvd Fl 6
Arlington, VA 22209-2281
Phone (888) 731-8994
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2021 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN267597 | MA | MD | Family Nurse Practitioner |
| 4704369510 | MI | MD | Family Nurse Practitioner |
| 143721 | MT | MD | Family Nurse Practitioner |
| 201709803NP-PP | OR | MD | Family Nurse Practitioner |
Interoperability endpoints
- suzanne.tither.1@19572.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1659629483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 FRAKER LOOP",
"city": "WHITEHALL",
"state": "MT",
"postal_code": "597598695",
"telephone_number": "443-223-9252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CAMBRIDGE ST FL 14",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142509",
"telephone_number": "888-731-8994"
}
],
"practiceLocations": [
{
"address_1": "111 N Orange Ave Ste 800",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328012381",
"country_code": "US",
"telephone_number": "443-223-9252",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3010 Santa Fe Ct Fl 1",
"address_purpose": "LOCATION",
"city": "Missoula",
"state": "MT",
"postal_code": "598081730",
"country_code": "US",
"telephone_number": "888-731-8994",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1101 Wilson Blvd Fl 6",
"address_purpose": "LOCATION",
"city": "Arlington",
"state": "VA",
"postal_code": "222092281",
"country_code": "US",
"telephone_number": "888-731-8994",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TITHER",
"first_name": "SUZANNE",
"middle_name": "TERSHAK",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-28",
"last_updated": "2024-04-19",
"certification_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024170298",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "201709803NP-PP",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704369510",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "RN267597",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MT",
"license": "143721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.