Susan Kay Halley, MS, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71000658 Issued in IN

Practice address

2001 Hobson Rd
Heritage Park
Fort Wayne, IN 46805-4872

Phone

(260) 484-9557

NPI assigned

Jul 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

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

• Eventus Ecs, Inc

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1073353496
  Medicare reassignment NPD
• Extended Care Specialists, Inc

  • Adult Medicine Physician
  • Merrillville, IN
  • NPI 1134146079

  Family

  Medicare reassignment NPD
• New Senior Care, LLC

  • General Practice Physician
  • Kokomo, IN
  • NPI 1801124953
  NPD (past)
• St Joseph Medical Group Inc

  • Family Medicine Physician
  • Angola, IN
  • NPI 1801851902
  NPD (past)
• Thomas P Van Den Driessche

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1538349956
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891716312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 OTSEGO DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468253844",
            "telephone_number": "260-483-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 HOBSON RD",
            "address_2": "HERITAGE PARK",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054872",
            "telephone_number": "260-484-9557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLEY",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "credential": "MS, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200239640",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald R Hall, M.D.
• Sean Hall, LMHC
• Shana R Hall, RBT
• Tacoy Hall
• Andrea Leigh Haller, MD
• Brittany Hallis, ATC, LAT
• Rachel Marie Hallman, FNP
• Claire Halluska, LCSW
• Gary A. Hambel, M.D.
• Sahar Hameed

• Family Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.