Individual provider Active NPI

Susan Lynn Hepburn, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Aurora, CO
National Provider Identifier
1740695816
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
0002875 Issued in CO
Practice address
13121 E 17TH Ave Ste C234
JFK Partners Education South Anschutz Medical Campus
Aurora, CO 80045-2596
Phone
(303) 724-5678
NPI assigned
Jun 26, 2014
Last updated
Jun 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 0002875 CO Primary

Addresses

Primary practice location

13121 E 17TH Ave Ste C234
JFK Partners Education South Anschutz Medical Campus
Aurora, CO 80045-2596

Mailing address

13121 E 17TH Ave Ste C234
JFK Partners Education South Anschutz Medical Campus
Aurora, CO 80045-2596
Phone (303) 724-5678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0002875COMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1740695816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13121 E 17TH AVE STE C234",
            "address_2": "JFK PARTNERS EDUCATION SOUTH ANSCHUTZ MEDICAL CAMPUS",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452596",
            "telephone_number": "303-724-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13121 E 17TH AVE STE C234",
            "address_2": "JFK PARTNERS EDUCATION SOUTH ANSCHUTZ MEDICAL CAMPUS",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452596",
            "telephone_number": "303-724-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEPBURN",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CO",
            "license": "0002875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; 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.