Individual provider Active NPI

Susan Howard Culverhouse, M.D.

  • Internal Medicine Physician
  • Port St Joe, FL
National Provider Identifier
1790979813
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME107608 Issued in FL
Practice address
3801 E Highway 98
Port St Joe, FL 32456-5318
Phone
(850) 932-3426
NPI assigned
Aug 31, 2007
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME107608 FL Primary

Addresses

Primary practice location

3801 E Highway 98
Port St Joe, FL 32456-5318

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

Other identifiers 1

IdentifierTypeStateIssuer
12145140OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101005001098 FL Practitioner - Internal MedicinePractitioner - Allergy/Immunology 0648462978 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Florida College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System, IncGroup PAC ID 5799763074, 19 clinicians

Practice addresses (Care Compare)

4451 Bayou Blvd
Pensacola, FL 32503-2601
Phone (850) 475-4620

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hni Hospital Services of Florida, LLC Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Hni Medical Services of Florida, LLC Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Jul 22, 2024 Accepting new patients
Team Radiology Physicians, PA Past Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

615 N Bonita Ave
Panama City, FL 32401
Phone (850) 747-2020

4451 Bayou Blvd
Pensacola, FL 32503
Phone (850) 416-7619

5153 N 9th Ave
Ste 302
Pensacola, FL 32504
Phone (850) 416-2250

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1790979813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 E HIGHWAY 98",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324565318",
            "telephone_number": "850-932-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULVERHOUSE",
        "first_name": "SUSAN",
        "middle_name": "HOWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME107608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12145140",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Joe, FL

Sources for this page

Verify at the official NPI Registry.