Individual provider Active NPI

Susan Elizabeth O'Neill, MSN, FNP-BC

  • Family Nurse Practitioner
  • Fort Lauderdale, FL
National Provider Identifier
1659788693
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9264748 Issued in FL
Practice address
4750 N Federal Hwy Ste 300
Fort Lauderdale, FL 33308-4609
Phone
(754) 206-2420
Fax
(954) 867-5583
NPI assigned
Jul 22, 2014
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9264748 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X RN 9264748 FL
Critical Care Medicine Registered Nurse 163WC0200X RN 9264748 FL

Addresses

Primary practice location

4750 N Federal Hwy Ste 300
Fort Lauderdale, FL 33308-4609

Mailing address

4750 N Federal Hwy Ste 300
Fort Lauderdale, FL 33308-4609
Phone (754) 206-2420

Other practice location 1

20888 NW 1st St
Pembroke Pines, FL 33029-2170
Phone (954) 505-7449

Other practice location 2

105 NE 3rd St
Fort Lauderdale, FL 33301
Phone (754) 206-2420

Other practice location 3

10775 Pioneer Trl Ste 215
Truckee, CA 96161-0234
Phone (415) 424-4266

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
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN 9264748FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Telehealth Services USA Past Accepting new patients
Marathon Health, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: susan.o.neill.1@14940.direct.athenahealth.com

Organizations & group practices 2

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1659788693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 N FEDERAL HWY STE 300",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084609",
            "telephone_number": "754-206-2420",
            "fax_number": "754-223-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 N FEDERAL HWY STE 300",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084609",
            "telephone_number": "754-206-2420",
            "fax_number": "954-867-5583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20888 NW 1st St",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330292170",
            "country_code": "US",
            "telephone_number": "954-505-7449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 NE 3rd St",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "33301",
            "country_code": "US",
            "telephone_number": "754-206-2420",
            "fax_number": "954-867-5583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10775 Pioneer Trl Ste 215",
            "address_purpose": "LOCATION",
            "city": "Truckee",
            "state": "CA",
            "postal_code": "961610234",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "MSN,  FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9264748",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "RN 9264748",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN 9264748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; 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.