Individual provider Active NPI

Susan Michele Brown, NNP-BC

  • Neonatal Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1750662144
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
59553 Issued in WV
Practice address
800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone
(304) 388-2252
NPI assigned
Aug 30, 2011
Last updated
Jun 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 59553 WV Primary

Addresses

Primary practice location

800 Pennsylvania Ave
Charleston, WV 25302-3351

Mailing address

5928 Wilson Dr
Huntington, WV 25705-2621
Phone (304) 633-5178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59553WVMDNeonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1750662144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5928 WILSON DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052621",
            "telephone_number": "304-633-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PENNSYLVANIA AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023351",
            "telephone_number": "304-388-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SUSAN",
        "middle_name": "MICHELE",
        "credential": "NNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WV",
            "license": "59553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.