Individual provider Active NPI

Suzan Page, N.P.

  • Adult Health Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1740716927
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
30230 Issued in TN
Practice address
1 Professional Park Dr Ste 21
Johnson City, TN 37604-6909
Phone
(423) 232-6900
NPI assigned
May 5, 2017
Last updated
Mar 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5012981 NC
Adult Health Nurse Practitioner 363LA2200X 30230 TN Primary
Gerontology Nurse Practitioner 363LG0600X APN.0993052.NP CO
Gerontology Nurse Practitioner 363LG0600X 30230 TN

Addresses

Primary practice location

1 Professional Park Dr Ste 21
Johnson City, TN 37604-6909

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

190 Riverview St
Franklin, NC 28734-2658
Phone (828) 349-6800

Other identifiers 1

IdentifierTypeStateIssuer
1740716927MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170711003038 CO Practitioner - Nurse Practitioner 5991074619
I20211208003089 TN Practitioner - Nurse Practitioner 5991074619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Colorado School of Medicine, Denver, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain States Health AllianceGroup PAC ID 6002726718, 23 clinicians

Practice addresses (Care Compare)

1 Professional Park Dr
Suite 21
Johnson City, TN 37604-6909
Phone (423) 232-6909

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5012981NCMDNurse Practitioner
APN.0993052.NPCOMDGerontology Nurse Practitioner
30230TNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince Aug 14, 2017 Accepting new patients
Mountain States Health Alliance CurrentSince Jan 1, 2024 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Mountain States Health Alliance Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Nov 5, 2021 Accepting new patients
Mountain States Health Alliance CurrentSince Jan 1, 2024 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Aug 14, 2017 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Nov 5, 2021 Accepting new patients
Mountain States Health Alliance Past Accepting new patients

Locations

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

7780 S Broadway
Ste 380
Littleton, CO 80122
Phone (303) 734-2090

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1 Professional Park Dr
Ste 21
Johnson City, TN 37604
Phone (423) 232-6900

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

1901 S Shady St
Mountain City, TN 37683
Phone (423) 727-1100

Organizations & group practices 10

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 5

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": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1740716927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PROFESSIONAL PARK DR STE 21",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046909",
            "telephone_number": "423-232-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 Riverview St",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "NC",
            "postal_code": "287342658",
            "country_code": "US",
            "telephone_number": "828-349-6800",
            "fax_number": "828-349-6810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGE",
        "first_name": "SUZAN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012981",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "30230",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.0993052.NP",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "30230",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740716927",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.