Individual provider Active NPI

Susan L Dennie, ARNP

  • Family Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1851629992
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP 30004097 Issued in WA
Practice address
3920 Capital Mall Dr SW Ste 200
Olympia, WA 98502-8701
Phone
(360) 596-4899
NPI assigned
Dec 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP 30004097 WA Primary

Addresses

Primary practice location

3920 Capital Mall Dr SW Ste 200
Olympia, WA 98502-8701

Mailing address

3920 Capital Mall Dr SW Ste 200
Olympia, WA 98502-8701
Phone (360) 596-4899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100316001036 WA Practitioner - Nurse Practitioner 2365577301 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP 30004097WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Medical Center Physicians LLC CurrentSince Jul 2, 2012 Accepting new patients
Capital Medical Center Physicians LLC CurrentSince Jul 2, 2012 Accepting new patients

Locations

3920 Capital Mall Dr SW
Ste 200
Olympia, WA 98502
Phone (360) 459-7282

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1851629992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 CAPITAL MALL DR SW STE 200",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028701",
            "telephone_number": "360-596-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 CAPITAL MALL DR SW STE 200",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028701",
            "telephone_number": "360-596-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIE",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP 30004097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.