Susan K Grove, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP107780 Issued in TX

Practice address

1801 S Carrier Pkwy
Grand Prairie, TX 75051-3702

Phone

(972) 262-5272

Fax

(972) 262-1921

NPI assigned

Sep 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Susan K Suggs Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1689044950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 S CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750513702",
            "telephone_number": "972-262-5272",
            "fax_number": "972-262-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750513702",
            "telephone_number": "972-262-5272",
            "fax_number": "972-262-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVE",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP107780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WMG MEDICARE",
            "identifier": "456712YLPS",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SUGGS",
            "middle_name": "K",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Gerontology Nurse Practitioner in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.