Suzanne Andrea Dubeck, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APN0000007482 Issued in TN

Practice address

111 Otis Smith Dr
Clarksville, TN 37043-8940

Phone

(931) 553-6666

NPI assigned

Feb 27, 2006

Last updated

Apr 11, 2018By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Premier Medical Group PC

  dba PMedical Group

  • General Practice Physician
  • Clarksville, TN
  • NPI 1740242957
  NPD (past)

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1891761144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OTIS SMITH DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438940",
            "telephone_number": "931-553-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OTIS SMITH DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438940",
            "telephone_number": "931-553-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Blanchfield Army Community Hospital",
            "address_2": "650 Joel Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Campbell",
            "state": "KS",
            "postal_code": "422235349",
            "country_code": "US",
            "telephone_number": "270-798-8372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBECK",
        "first_name": "SUZANNE",
        "middle_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "RN0000112635",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "APN0000007482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q022026",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Renee Drew
• Matthew Theodore Drew, O.D.
• David Lee Driskell, PA-C
• Jana Rae Drumright, PHARMD
• Jincheng Du, D.D.S.
• Jeremy Dubose
• Gloria Dudley
• Jenna Kristine Dueball
• Mary Dueker, OT
• Timothy K Duffin, MD

• Pediatric Nurse Practitioner in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.