Susan Rae Ault, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

14768 Issued in CA

Practice address

2830 East St
Anderson, CA 96007-3408

Phone

(530) 365-2545

Fax

(530) 365-3871

NPI assigned

Aug 22, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Palliative Care Services, Inc.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Coos Bay, OR
  • NPI 1861491813
  NPD (past)
• South Coast Hospice & Palliative Care Services Inc

  • Community Based Hospice Care Agency
  • Coos Bay, OR
  • NPI 1417956558
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1790777100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 EAST ST",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073408",
            "telephone_number": "530-365-2545",
            "fax_number": "530-365-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 EAST ST",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073408",
            "telephone_number": "530-365-2545",
            "fax_number": "530-365-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AULT",
        "first_name": "SUSAN",
        "middle_name": "RAE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OR",
            "license": "083045668RN",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "200450018NP",
            "primary": false
        },
        {
            "code": "364SX0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": "OR",
            "license": "200570025CNS",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "14768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278215",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1407812365",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN NUMBER",
            "identifier": "R0000WFBTV",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Anderson
• Andersonrx Inc
• Andersonrx LTC
• Fredrick Argueta Jr., MEDICAL DRIVER
• Lauren S Armstrong, RN
• Brian S. Baas, PT
• Rachna Badlani
• Joanne M Bales, O.T.R.
• Cristina Beachner
• Jessica Renee Benett

• Family Nurse Practitioner in Anderson, CA
• Providers in Anderson, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.