Individual provider Active NPI

Susan Renae Carlton, ARNP

  • Family Nurse Practitioner
  • Rochester, WA
National Provider Identifier
1710684105
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61410451 Issued in WA
Practice address
18313 Paulson St SW Ste a
Rochester, WA 98579-9262
Phone
(360) 827-8400
NPI assigned
Feb 15, 2023
Last updated
Apr 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61410451 WA Primary
Family Medicine Physician 207Q00000X AP61410451 WA

Addresses

Primary practice location

18313 Paulson St SW Ste a
Rochester, WA 98579-9262

Mailing address

18313 Paulson St SW Ste a
Rochester, WA 98579-9262
Phone (360) 827-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230419001723 WA Practitioner - Nurse Practitioner 8921473208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services - WashingtonGroup PAC ID 2365427556, 9 clinicians

Practice addresses (Care Compare)

1010 S Scheuber Rd
Suite 3/4
Centralia, WA 98531-8892
Phone (360) 827-7966

18313 Paulson St SW
Suite a
Rochester, WA 98579-9262
Phone (360) 827-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61410451WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Providence Health & Services - Washington CurrentSince Mar 1, 2023 Accepting new patients

Locations

1620 Cooper Point Rd SW
Olympia, WA 98502
Phone (360) 486-6710

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

18313 Paulson St SW
Ste A
Rochester, WA 98579
Phone (360) 273-8818

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.

Hospital & facility affiliations 3

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": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1710684105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18313 PAULSON ST SW STE A",
            "city": "ROCHESTER",
            "state": "WA",
            "postal_code": "985799262",
            "telephone_number": "360-827-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18313 PAULSON ST SW STE A",
            "city": "ROCHESTER",
            "state": "WA",
            "postal_code": "985799262",
            "telephone_number": "360-827-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLTON",
        "first_name": "SUSAN",
        "middle_name": "RENAE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61410451",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "AP61410451",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, WA

Sources for this page

Verify at the official NPI Registry.