Individual provider Active NPI

Susan M Dungan, NP

  • Acute Care Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1780751479
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN089268 AP04806 Issued in LA
Practice address
1811 E Bert Kouns
Suite 100
Shreveport, LA 71105
Phone
(318) 222-3695
Fax
(318) 424-0717
NPI assigned
Nov 29, 2006
Last updated
Jun 17, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN089268 AP04806 LA Primary

Addresses

Primary practice location

1811 E Bert Kouns
Suite 100
Shreveport, LA 71105

Mailing address

1844 Glen Cove Dr
Benton, LA 71006-8414
Phone (318) 965-4341

Other identifiers 1

IdentifierTypeStateIssuer
1409537MedicaidLA

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN089268 AP04806LAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ark-la-Tex Cardiology, Apmc Past Accepting new patients
Cardiology Associates-a Medical Corporation Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245196800000",
    "number": "1780751479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 GLEN COVE DR",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710068414",
            "telephone_number": "318-965-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS",
            "address_2": "SUITE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-222-3695",
            "fax_number": "318-424-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNGAN",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2009-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "RN089268 AP04806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1409537",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.