Individual provider Active NPI

Susan Jane Akins, MSN RN BC AP MHCNS

  • Clinical Nurse Specialist
  • Saint Louis, MO
National Provider Identifier
1790767721
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
048345 Issued in MO
Practice address
3535 S Jefferson Ave
Suite 118
Saint Louis, MO 63118-3930
Phone
(314) 776-7999
Fax
(314) 772-2257
NPI assigned
Nov 16, 2005
Last updated
Dec 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 048345 MO Primary
Clinical Nurse Specialist 364S00000X 209004686 IL

Addresses

Primary practice location

3535 S Jefferson Ave
Suite 118
Saint Louis, MO 63118-3930

Mailing address

2120 Madison Ave
Ste 404
Granite City, IL 62040-4744
Phone (618) 876-7515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070717000559 MO Practitioner - Certified Clinical Nurse Specialist (CNS) 1456451616 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
048345MOMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Behavioral Health LLC Past Accepting new patients
Mid-America Psychiatric Consultants, LLC PastSince Jun 30, 2000 Accepting new patients

Organizations & group practices 3

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1790767721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 MADISON AVE",
            "address_2": "STE 404",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404744",
            "telephone_number": "618-876-7515",
            "fax_number": "618-876-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S JEFFERSON AVE",
            "address_2": "SUITE 118",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183930",
            "telephone_number": "314-776-7999",
            "fax_number": "314-772-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKINS",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "credential": "MSN RN BC AP MHCNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MO",
            "license": "048345",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IL",
            "license": "209004686",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.