Individual provider Active NPI

Susanna Hope Jefferson, CRNP

  • Nurse Practitioner
  • Gardendale, AL
National Provider Identifier
1871236133
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-162570 Issued in AL
Practice address
919 Odum Rd
Gardendale, AL 35071-3600
Phone
(865) 643-2221
NPI assigned
Apr 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-162570 AL Primary

Addresses

Primary practice location

919 Odum Rd
Gardendale, AL 35071-3600

Mailing address

6404 Glenview Cir
Gardendale, AL 35071-2102
Phone (865) 643-2221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240715003476 AL Practitioner - Nurse Practitioner 1456896380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Family Care, LLCGroup PAC ID 9739087818, 180 clinicians

Practice addresses (Care Compare)

1652 Montclair Rd
Irondale, AL 35210-2410
Phone (205) 956-9192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-162570ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Family Care, LLC CurrentSince Apr 28, 2024 Accepting new patients
American Family Care, LLC CurrentSince Apr 28, 2024 Accepting new patients

Locations

120 Colonial Promenade Pkwy
Alabaster, AL 35007
Phone (205) 605-0495

919 Odum Rd
Gardendale, AL 35071
Phone (205) 351-0149

3700 Cahaba Beach Rd
Hoover, AL 35242
Phone (205) 403-8902

8151 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 882-9711

1652 Montclair Rd
Irondale, AL 35210
Phone (205) 263-8623

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": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1871236133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 GLENVIEW CIR",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350712102",
            "telephone_number": "865-643-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 ODUM RD",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350713600",
            "telephone_number": "865-643-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "SUSANNA",
        "middle_name": "HOPE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2025-05-01",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-162570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardendale, AL

Sources for this page

Verify at the official NPI Registry.