Individual provider Active NPI

Susan F Burroughs, MD

  • Hematology & Oncology Physician
  • Vernon, CT
National Provider Identifier
1790781078
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
030948 Issued in CT
Practice address
400 Talcottville Rd # 1
Vernon, CT 06066-4051
Phone
(860) 896-4718
Fax
(860) 896-1426
NPI assigned
Jun 22, 2005
Last updated
Sep 4, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 030948 CT Primary

Addresses

Primary practice location

400 Talcottville Rd # 1
Vernon, CT 06066-4051

Mailing address

196 Parkway S
Suite 304
Waterford, CT 06385-1234
Phone (860) 442-7027

Other identifiers 1

IdentifierTypeStateIssuer
001309485MedicaidCT

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Morgan MD Past Accepting new patients

Organizations & group practices 1

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1790781078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 304",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-442-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TALCOTTVILLE RD # 1",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664051",
            "telephone_number": "860-896-4718",
            "fax_number": "860-896-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "SUSAN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CT",
            "license": "030948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001309485",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.