Individual provider Active NPI

Susan Belk Thiessen, CRNA

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1891931887
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
132662 Issued in NC
Practice address
2825 Randolph Rd
Charlotte, NC 28211-1018
Phone
(704) 377-1647
NPI assigned
Dec 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 132662 NC Primary

Addresses

Primary practice location

2825 Randolph Rd
Charlotte, NC 28211-1018

Mailing address

PO Box 32861
Anesthesia Services - 5TH Floor Surgical Tower
Charlotte, NC 28232-2861
Phone (704) 355-8983

Other practice location 1

1000 Blythe Blvd
anesthesia services -5th floor surgical tower
Charlotte, NC 28203-5812
Phone (704) 355-8983

Other identifiers 2

IdentifierTypeStateIssuer
8053699MedicaidNC
SC NAN 921MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090822000146 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779637269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

2825 Randolph Rd
Charlotte, NC 28211-1018
Phone (704) 377-1647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
132662NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Anesthesia Services Group Inc CurrentSince Nov 20, 2017 Accepting new patients
East Carolina Anesthesia Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince May 20, 2019 Accepting new patients
Charlotte Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
Mercy Hospital, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1000 Blythe Blvd
Fl 5
Charlotte, NC 28203
Phone (704) 355-8983

2825 Randolph Rd
Charlotte, NC 28211
Phone (704) 377-1647

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

2080 W Arlington Blvd
Ste B
Greenville, NC 27834
Phone (252) 752-2140

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

Organizations & group practices 4

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": "1229990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1891931887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32861",
            "address_2": "ANESTHESIA SERVICES - 5TH FLOOR SURGICAL TOWER",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282322861",
            "telephone_number": "704-355-8983",
            "fax_number": "704-355-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111018",
            "telephone_number": "704-377-1647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Blythe Blvd",
            "address_2": "anesthesia services -5th floor surgical tower",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-8983",
            "fax_number": "704-355-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIESSEN",
        "first_name": "SUSAN",
        "middle_name": "BELK",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-23",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "132662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8053699",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SC NAN 921",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.