Susanne Fine, PSY.D., RN, CNS

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1546 Issued in OR

Practice address

1117 E Main St
Medford, OR 97504-7404

Phone

(541) 245-1123

NPI assigned

Dec 6, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

State licenses

Practice roles

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.

• Dr. Susanne Fine, LLC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Medford, OR
  • NPI 1366427759
  NPD (past) Authorized official

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1720062490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047404",
            "telephone_number": "541-245-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047404",
            "telephone_number": "541-245-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "SUSANNE",
        "credential": "PSY.D., RN, CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1546",
            "primary": true
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "OR",
            "license": "200870007CNS-PP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST",
            "identifier": "#1546",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL NURSE PRACTTIONER/ARNP",
            "identifier": "200870007CNS-PP",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Filoon, FNP
• Finbar Nursing Anesthesia Services a Professional Corporation
• Find a Light Counseling LLC
• Amy B Fine, DMD
• Joshua David Fine, D.C.
• Hannah E Finear, LMT
• McKenna Finney, RDH
• Eleonora Fiorletta Quiroga, M.D.
• First Choice Eldercare LLC
• Amanda K Fischer, AGACNP

• Clinical Psychologist in Medford, OR
• Providers in Medford, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.