NPIMap

Individual provider Active NPI

Susan Lamb, ANP

  • Family Nurse Practitioner
  • Ft Collins, CO
National Provider Identifier
1962575001
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0996558-NP Issued in CO
Practice address
1025 Penncock Place #121
Ft Collins, CO 80528-8052
Phone
(970) 495-8800
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 774 AK
Family Nurse Practitioner 363LF0000X APN.0996558-NP CO Primary

Addresses

Primary practice location

1025 Penncock Place #121
Ft Collins, CO 80528-8052

Mailing address

4212 Goldeneye Dr
Fort Collins, CO 80526-3637
Phone (907) 360-6968

Other identifiers 3

IdentifierTypeStateIssuer
1730113739OtherPFMC CLINIC NPI
743109721OtherTAX ID
NP99111MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170321000309 TX Practitioner - Nurse Practitioner 9335197334 Reassigns benefits to 1 organization
I20220215000641 CO Practitioner - Nurse Practitioner 9335197334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Health Care IncGroup PAC ID 7618880709, 56 clinicians

Practice addresses (Care Compare)

1025 Pennock PL
Suite 121
Fort Collins, CO 80524-3250
Phone (970) 495-8980

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
744AKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Alaska Regional Health Consortium CurrentSince Feb 23, 2017 Accepting new patients
Poudre Valley Health Care,Inc CurrentSince Feb 21, 2022 Accepting new patients
Poudre Valley Health Care Inc CurrentSince Feb 21, 2022 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Poudre Valley Health Care Inc. Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Feb 23, 2017 Accepting new patients
Heart of Eagle River Medical Clinic Past Accepting new patients

Locations

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

1025 Pennock Pl
#121
Fort Collins, CO 80524
Phone (970) 495-8800

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

1025 Pennock Pl
Ste 121
Fort Collins, CO 80524
Phone (970) 495-8800

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 7

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1962575001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 GOLDENEYE DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805263637",
            "telephone_number": "907-360-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 PENNCOCK PLACE #121",
            "city": "FT COLLINS",
            "state": "CO",
            "postal_code": "805288052",
            "telephone_number": "970-495-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMB",
        "first_name": "SUSAN",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2022-02-21",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "774",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0996558-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PFMC CLINIC NPI",
            "identifier": "1730113739",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "743109721",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP99111",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Collins, CO

Sources for this page

Verify at the official NPI Registry.