Individual provider Active NPI

Susanna McClarty, RN NURSE PRACTITIONE

  • Family Nurse Practitioner
  • Costa Mesa, CA
National Provider Identifier
1851476642
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7269 Issued in CA
Practice address
601 W 19TH St
Planned Parenthood of Orange and San Bernadino Counties
Costa Mesa, CA 92627
Phone
(949) 548-8830
Fax
(949) 548-9051
NPI assigned
Oct 27, 2006
Last updated
Mar 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN246446 CA
Family Nurse Practitioner 363LF0000X 7269 CA Primary

Addresses

Primary practice location

601 W 19TH St
Planned Parenthood of Orange and San Bernadino Counties
Costa Mesa, CA 92627

Mailing address

PO Box 3391
Seal Beach, CA 90740-2391
Phone (562) 237-7021

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
RN246446CAMDRegistered Nurse
7269CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1851476642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3391",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402391",
            "telephone_number": "562-237-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 19TH ST",
            "address_2": "PLANNED PARENTHOOD OF ORANGE AND SAN BERNADINO COUNTIES",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92627",
            "telephone_number": "949-548-8830",
            "fax_number": "949-548-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLARTY",
        "first_name": "SUSANNA",
        "name_prefix": "Ms.",
        "credential": "RN NURSE PRACTITIONE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN246446",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "7269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.