Mary Susan Emerson, APRN, PHD

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

063436 Issued in MO

Practice address

2616 Tumble Brook Dr
Las Vegas, NV 89134-7869

Phone

(918) 606-0505

NPI assigned

Jul 15, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

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.

• University Health Physicians

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1669456257
  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1790784452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 TUMBLE BROOK DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891347869",
            "telephone_number": "918-606-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 TUMBLE BROOK DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891347869",
            "telephone_number": "918-606-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "MARY",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "APRN, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "063436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425324506",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Emerick
• Emeritus Corporation
• Emeritus Corporation
• Emeritus Properties NGH, LLC
• Candace Emerson
• Nawatha Emerson
• Toni Marie Emerson, PMHNP
• Carmen Rene Emery, MD
• Jasmine Emery
• John Albert Emery Jr., B.A.

• All providers in Las Vegas, NV
• Adult Health Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.