Susan B Slattery, CNM, WHNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

14663 Issued in WI

Practice address

99 Central Ave
Ashland, OR 97520-1787

Phone

(541) 482-9741

Fax

(541) 488-6141

NPI assigned

May 31, 2006

Last updated

Nov 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1821035031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047337",
            "telephone_number": "541-482-9741",
            "fax_number": "541-488-6141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 CENTRAL AVE",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201787",
            "telephone_number": "541-482-9741",
            "fax_number": "541-488-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTERY",
        "first_name": "SUSAN",
        "middle_name": "B",
        "credential": "CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "14663",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OR",
            "license": "200850169NP",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "200850169NP",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209-001582",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "200850169NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041-305999",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON LICENSE",
            "identifier": "200850169NP",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE",
            "identifier": "209-001582",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Ashland, OR
• Providers in Ashland, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.