Susan Prouse

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN170978 Issued in GA

Practice address

1408 Tallahassee Hwy Ste Z
Bainbridge, GA 39819-7900

Phone

(229) 400-9033

NPI assigned

Jun 29, 2021

Last updated

Jun 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rural Urgent Care LLCGroup PAC ID 8820305600, shared by 21 NPIs, 171 clinicians

TMH Emergency Physician GroupGroup PAC ID 8325317084, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sprouse21998@tallahasseememorial.direct-ci.com

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.

• TMH Emergency Physician Group

  • Emergency Medicine Physician
  • Tallahassee, FL
  • NPI 1417483819
  Medicare reassignment Care Compare group NPD
• Rural Urgent Care LLC

  dba MainStreet Family Care

  • Urgent Care Clinic/Center
  • Quincy, FL
  • NPI 1881353670
  Medicare reassignment NPD
• Rural Urgent Care LLC

  • Urgent Care Clinic/Center
  • Centre, AL
  • NPI 1932586476

  GA

  Medicare reassignment NPD
• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Medicare reassignment NPD
• Rural Urgent Care LLC

  dba MainStreet Family Care

  • Rural Health Clinic/Center
  • Eufaula, AL
  • NPI 1588450316
  NPD
• Tallahassee Memorial Healthcare Inc

  dba TMH Physician Partners

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1366293102
  NPD
• Tallahassee Memorial Healthcare Inc

  dba TMHPP Anesthesiology PCB

  • Anesthesiology Physician
  • Panama City Beach, FL
  • NPI 1992532477
  NPD
• TMH Emergency Physician Group

  • Emergency Medicine Physician
  • Tallahassee, FL
  • NPI 1235665605
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1689244063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 1ST AVE N UNIT 3",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 TALLAHASSEE HWY STE Z",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398197900",
            "telephone_number": "229-400-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUSE",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN170978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Elise Price, LCSW
• Winston Price, M.D.
• Primary Care Inc
• Primary Care of Southwest Georgia, Inc. (Primary Care of Southwest Georgia- Bainbridge)
• Promise Kept Psychiatric and Consultation Services, LLC
• Publix Super Markets, Inc. (Publix Pharmacy #2109)
• Alec Radulski, PHARMD
• Breauina Shontell Reddick
• Sedrianna Shanta Reels
• Renex Dialysis Clinic of South Georgia, Inc. (RCG Bainbridge)

• Family Nurse Practitioner in Bainbridge, GA
• Providers in Bainbridge, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.