Susan Lee McKenna

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Practice address

2730 University Blvd W
Silver Spring, MD 20902-1905

Phone

(301) 933-6680

NPI assigned

Apr 12, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Susan Lee Leavitt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1902303290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 LYTTONSVILLE RD APT 409",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209102236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 UNIVERSITY BLVD W",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209021905",
            "telephone_number": "301-933-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "SUSAN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "LEAVITT",
            "middle_name": "LEE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Patrick McIntyre, D.D.S.
• Stacey M. McIntyre, BCBA
• Teneisha McIntyre, PHD
• Gillian McKeever, MT-BC
• Sherri Sue McKenna, MSW
• Deanne Michelle McKenzie, MD
• Nya Steinbergen McKenzie, DPT
• Helen McKibben
• Theresa McKillop, MSW, LISW-AP
• Geselle Meader McKnight, CRNA

• Federally Qualified Health Center (FQHC) in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Federally Qualified Health Center (FQHC) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.