NPIMap

Individual provider Active NPI

Suzanne Baughn, NP

  • Family Nurse Practitioner
  • Manchester, MA
National Provider Identifier
1770626517
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214616 Issued in MA
Practice address
195 School St
Manchester, MA 01944-1700
Phone
(978) 526-4311
Fax
(978) 525-2342
NPI assigned
Feb 14, 2007
Last updated
Mar 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 214616 MA Primary

Addresses

Primary practice location

195 School St
Manchester, MA 01944-1700

Mailing address

195 School St
Manchester, MA 01944-1700
Phone (978) 526-4311

Other names 1

  • Suzanne K Clark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050912000887 MA Practitioner - Nurse Practitioner 5597798470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Congenial Healthcare LLCGroup PAC ID 5395011522, 12 clinicians

Practice addresses (Care Compare)

1 Roosevelt Ave
Suite 201
Peabody, MA 01960-2227
Phone (978) 536-0215

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214616MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Congenial Healthcare, LLC CurrentSince Apr 1, 2018 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Sep 9, 2017 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Sep 9, 2017 Accepting new patients
Congenial Healthcare, LLC Current Accepting new patients
Congenial Healthcare, LLC Past Accepting new patients

Locations

195 School St
Manchester by the Sea, MA 01944
Phone (978) 526-4311

1 Roosevelt Ave
Ste 201
Peabody, MA 01960
Phone (978) 536-0215

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1770626517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 SCHOOL ST",
            "city": "MANCHESTER",
            "state": "MA",
            "postal_code": "019441700",
            "telephone_number": "978-526-4311",
            "fax_number": "978-525-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 SCHOOL ST",
            "city": "MANCHESTER",
            "state": "MA",
            "postal_code": "019441700",
            "telephone_number": "978-526-4311",
            "fax_number": "978-525-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUGHN",
        "first_name": "SUZANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "214616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "CLARK",
            "middle_name": "K",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, MA

Sources for this page

Verify at the official NPI Registry.