Individual provider Active NPI

Susan Marie Hancock, M.D.

  • Vascular Surgery Physician
  • Newport News, VA
National Provider Identifier
1942491790
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0101242791 Issued in VA
Practice address
603 Pilot House Dr
Ste 240
Newport News, VA 23606-1904
Phone
(910) 612-5118
Fax
(757) 873-0246
NPI assigned
Aug 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 0101242791 VA Primary

Addresses

Primary practice location

603 Pilot House Dr
Ste 240
Newport News, VA 23606-1904

Mailing address

119 James Landing Rd
Newport News, VA 23606-2052
Phone (910) 612-5118

Other identifiers 1

IdentifierTypeStateIssuer
1942491790MedicaidVA

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1942491790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 JAMES LANDING RD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062052",
            "telephone_number": "910-612-5118",
            "fax_number": "757-873-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 PILOT HOUSE DR",
            "address_2": "STE 240",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061904",
            "telephone_number": "910-612-5118",
            "fax_number": "757-873-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2022-09-14",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101242791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942491790",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.