Active NPI
Susan Joann Spear, RN
- General Practice Registered Nurse
- Rogers, AR
National Provider Identifier
1891333183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- R084531
- Practice address
- 3400 N Woods LN
Rogers, AR 72756-6712 - Phone
- (479) 636-3190
- Fax
- (479) 636-4587
- NPI assigned
- Dec 17, 2019
- 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 |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | R084531 | AR | Primary |
Addresses
Primary practice location
3400 N Woods LN
Rogers, AR 72756-6712
Mailing address
3400 N Woods LN
Rogers, AR 72756-6712
Phone (479) 636-3190
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R084531 | Other | AR | RN LICENSE |
Other names 1
- Susan Joann Russo
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | susan.spear@nwasunshineschool.org |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R084531 | AR | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576540800000",
"number": "1891333183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 N WOODS LN",
"city": "ROGERS",
"state": "AR",
"postal_code": "727566712",
"telephone_number": "479-636-3190",
"fax_number": "479-636-4587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 N WOODS LN",
"city": "ROGERS",
"state": "AR",
"postal_code": "727566712",
"telephone_number": "479-636-3190",
"fax_number": "479-636-4587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEAR",
"first_name": "SUSAN",
"middle_name": "JOANN",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-17",
"last_updated": "2019-12-17",
"certification_date": "2019-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "AR",
"license": "R084531",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "R084531",
"state": "AR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "susan.spear@nwasunshineschool.org",
"affiliation": "N",
"address_1": "3 Hanna Dr",
"city": "Bentonville",
"state": "AR",
"country_code": "US",
"postal_code": "727124045",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "RUSSO",
"middle_name": "JOANN",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.