Individual provider Active NPI

Susan Lynn Cummings, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lacey, WA
National Provider Identifier
1881971018
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60252120 Issued in WA
Practice address
4405 7TH Ave SE Ste 200
Lacey, WA 98503-1055
Phone
(360) 504-6128
Fax
(903) 213-9044
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60252120 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60252120 WA Primary

Addresses

Primary practice location

4405 7TH Ave SE Ste 200
Lacey, WA 98503-1055

Mailing address

4570 Avery LN SE Ste C-372
Lacey, WA 98503-5608
Phone (360) 207-0105

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
I20120123000422 WA Practitioner - Nurse Practitioner 3678740248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Washington University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4405 7TH Ave SE
Suite 200 2001
Lacey, WA 98503-1062
Phone (360) 207-0105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP60252120WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spurgeon Creek Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jul 6, 2023 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients

Locations

4405 7th Ave SE
Ste 200
Lacey, WA 98503
Phone (360) 200-8071

4405 7th Ave SE
Ste 2002001
Lacey, WA 98503
Phone (360) 207-0105

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: susan.cummings.1@14215.direct.athenahealth.com

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": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1881971018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 AVERY LN SE STE C-372",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035608",
            "telephone_number": "360-207-0105",
            "fax_number": "903-213-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 7TH AVE SE STE 200",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031055",
            "telephone_number": "360-504-6128",
            "fax_number": "903-213-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60252120",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60252120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "UW Medical Center 1959 NE Pacific St",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981950001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.