Individual provider Active NPI

Suzann Chesebrough-Pruitt, R.N.

  • Community Health Registered Nurse
  • Henderson, NV
National Provider Identifier
1811232275
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN25706 Issued in NV
Practice address
520 E Lake Mead Pkwy
Henderson, NV 89015-5578
Phone
(702) 759-0889
Fax
(702) 558-3127
NPI assigned
Dec 11, 2012
Last updated
Dec 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 378571 CA
Community Health Registered Nurse 163WC1500X RN25706 NV Primary

Addresses

Primary practice location

520 E Lake Mead Pkwy
Henderson, NV 89015-5578

Mailing address

1349 W Horizon Ridge Pkwy
#921
Henderson, NV 89012-2464
Phone (702) 606-5635

Other identifiers 2

IdentifierTypeStateIssuer
RN25706OtherNVRN LICENSE
378571OtherCAR.N. LICENSE

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
378571CAMDCommunity Health Registered Nurse
RN25706NVMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1811232275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1349 W HORIZON RIDGE PKWY",
            "address_2": "#921",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890122464",
            "telephone_number": "702-606-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890155578",
            "telephone_number": "702-759-0889",
            "fax_number": "702-558-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESEBROUGH-PRUITT",
        "first_name": "SUZANN",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "378571",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NV",
            "license": "RN25706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN25706",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.N. LICENSE",
            "identifier": "378571",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; 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.