Suzette Scipio - Ettienne, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0046373 Issued in MD

Practice address

2905 Mitchellville Rd
Ste 115
Bowie, MD 20716-1385

Phone

(301) 390-7960

Fax

(301) 218-2800

NPI assigned

Nov 17, 2006

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

• Suzette Scipio Ettienne Professional name

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: suzette.scipio.ettienne.1@7993.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/7993/brand/1/csg/1/fhir/r4

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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC, MD, Pediatrics

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Ettienne'S Premier Pediatric Care LLC

  • Pediatrics Physician
  • Bowie, MD
  • NPI 1841408697
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1730252594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 MITCHELLVILLE RD",
            "address_2": "STE 115",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161385",
            "telephone_number": "301-390-7960",
            "fax_number": "301-218-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 MITCHELLVILLE RD",
            "address_2": "STE 115",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161385",
            "telephone_number": "301-390-7960",
            "fax_number": "301-218-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIPIO - ETTIENNE",
        "first_name": "SUZETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0046373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363101000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZETTE",
            "last_name": "ETTIENNE",
            "middle_name": "SCIPIO",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sbest Choice Community Health and Home Services, Inc.
• Angela Schneider, M.S. CCC-SLP
• Judith Ruth Schneider, PA C
• Sherri O Schnell, OTR/L
• Angela R Schrout, AU.D.
• Scott Counseling Services
• Marvelyn Ann Scott Fowler, LCSW-C
• Doris Scott, CEO
• Nateeka Dainise Scott, LCPC
• SCW Healthcare Enterprises

• Pediatrics Physician in Bowie, MD
• Providers in Bowie, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.