Active NPI
Susan L Moulton, WHNP
- Women's Health Nurse Practitioner
- Flint, MI
National Provider Identifier
1841337383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 4704104617
- Practice address
- 2284 S Ballenger Hwy
Suite H
Flint, MI 48503-3446 - Phone
- (810) 233-5211
- NPI assigned
- Feb 1, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 4704104617 | MI | Primary |
Addresses
Primary practice location
2284 S Ballenger Hwy
Suite H
Flint, MI 48503-3446
Mailing address
2284 S Ballenger Hwy
Suite H
Flint, MI 48503-3446
Phone (810) 233-5211
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4416010 | Medicaid | MI | |
| OM32030 | Other | MI | MEDICARE GROUP |
| 5008767180 | Other | MI | BCBS ID |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hurley Health Services | Women's Health | Past | Accepting new patients |
Interoperability endpoints
- susanmoulton@direct.meditouchehr.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452038400000",
"number": "1841337383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2284 S BALLENGER HWY",
"address_2": "SUITE H",
"city": "FLINT",
"state": "MI",
"postal_code": "485033446",
"telephone_number": "810-233-5211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2284 S BALLENGER HWY",
"address_2": "SUITE H",
"city": "FLINT",
"state": "MI",
"postal_code": "485033446",
"telephone_number": "810-233-5211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULTON",
"first_name": "SUSAN",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "WHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-01",
"last_updated": "2016-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MI",
"license": "4704104617",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4416010",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "OM32030",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ID",
"identifier": "5008767180",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.