Individual provider Active NPI

Susan S McMillan, ARNP

  • Family Nurse Practitioner
  • Belle Glade, FL
National Provider Identifier
1710060421
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN1951902 Issued in FL
Practice address
425 SE 2ND Street
Belle Glade, FL 33430-3511
Phone
(561) 992-0508
Fax
(561) 992-0510
NPI assigned
Oct 24, 2006
Last updated
Nov 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN1951902 FL Primary

Addresses

Primary practice location

425 SE 2ND Street
Belle Glade, FL 33430-3511

Mailing address

425 SE 2ND St
Belle Glade, FL 33430-3511
Phone (561) 992-0508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080126000012 FL Practitioner - Nurse Practitioner 4082796255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

425 SE 2ND St
Belle Glade, FL 33430-3511
Phone (561) 992-0508

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN1951902FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Medical Center PLLC Family CurrentSince Feb 1, 2014 Accepting new patients
Glades Primary Care LLC Past Accepting new patients
Venra Medical Associates LLC Past Accepting new patients
My Doctor PA Past Accepting new patients

Locations

425 SE 2nd St
Belle Glade, FL 33430
Phone (561) 500-5347

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1710060421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 SE 2ND ST",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334303511",
            "telephone_number": "561-992-0508",
            "fax_number": "561-992-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 SE 2ND STREET",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334303511",
            "telephone_number": "561-992-0508",
            "fax_number": "561-992-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "SUSAN",
        "middle_name": "S",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN1951902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle Glade, FL

Sources for this page

Verify at the official NPI Registry.