Active NPI
Susan J Maxcy, RN, BSN, CDE
- Registered Nurse
- Scottsbluff, NE
National Provider Identifier
1831327733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 25917
- Practice address
- 3911 Avenue B Ste 1110
Scottsbluff, NE 69361-4617 - Phone
- (308) 220-4303
- Fax
- (308) 630-2139
- NPI assigned
- Jun 30, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | 2061-0243 | NE | |
| Registered Nurse | 163W00000X | 25917 | NE | Primary |
Addresses
Primary practice location
3911 Avenue B Ste 1110
Scottsbluff, NE 69361-4617
Mailing address
3911 Avenue B Ste 1110
Scottsbluff, NE 69361-4617
Phone (308) 220-4303
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025668100 | Medicaid | NE |
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
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2061-0243 | NE | MD | Diabetes Educator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246320000000",
"number": "1831327733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3911 AVENUE B STE 1110",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614617",
"telephone_number": "308-220-4303",
"fax_number": "308-630-2139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3911 AVENUE B STE 1110",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614617",
"telephone_number": "308-220-4303",
"fax_number": "308-630-2139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXCY",
"first_name": "SUSAN",
"middle_name": "J",
"credential": "RN, BSN, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-30",
"last_updated": "2009-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "NE",
"license": "2061-0243",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NE",
"license": "25917",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025668100",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scottsbluff, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.