Active NPI
Susu Hankhin
- Pediatrics Physician
- Jacksonville, FL
National Provider Identifier
1750345773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 74058
- Practice address
- 2080 Child St
Jacksonville, FL 32214-5005 - Phone
- (904) 542-7765
- NPI assigned
- Apr 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 74058 | FL | Primary |
Addresses
Primary practice location
2080 Child St
Jacksonville, FL 32214-5005
Mailing address
6520 Fort Caroline Rd
Jacksonville, FL 32277-2044
Phone (904) 745-3618
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74058 | Other | FL | LICENSE NUMBER |
| 273374 | Medicaid | FL |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74058 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1750345773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6520 FORT CAROLINE RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322772044",
"telephone_number": "904-745-3618",
"fax_number": "904-722-4271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 CHILD ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322145005",
"telephone_number": "904-542-7765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANKHIN",
"first_name": "SUSU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "74058",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "74058",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "273374",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.