Individual provider Active NPI

Susan E Herbst, PN MS AOCN

  • Oncology Clinical Nurse Specialist
  • Coeur D Alene, ID
National Provider Identifier
1679567465
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Clinical Nurse SpecialistTaxonomy code 364SX0200X
License
CNS-10A Issued in ID
Practice address
2000 Kootenai Health Way
Coeur D Alene, ID 83814
Phone
(208) 666-2000
Fax
(208) 666-3963
NPI assigned
Sep 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Clinical Nurse Specialist 364SX0200X CNS-10A ID Primary

Addresses

Primary practice location

2000 Kootenai Health Way
Coeur D Alene, ID 83814

Mailing address

2000 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 666-2000

Other identifiers 1

IdentifierTypeStateIssuer
806210600MedicaidID

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
Certified Nurse Specialist, Master of Science, Advanced Practice Nurse

State licenses

LicenseStateTypeSpecialty
CNS-10AIDMDOncology Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Incyte Pathology, PLLC Current Accepting new patients

Locations

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

Organizations & group practices 1

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1679567465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-666-2000",
            "fax_number": "208-666-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-666-2000",
            "fax_number": "208-666-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBST",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "PN MS AOCN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SX0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": "ID",
            "license": "CNS-10A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806210600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.