Individual provider Active NPI

Susan Hamilton, MSN FNP-BC

  • Family Nurse Practitioner
  • Merritt Island, FL
National Provider Identifier
1972383891
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11028235 Issued in FL
Practice address
390 N Courtenay Pkwy
Merritt Island, FL 32953-3456
Phone
(321) 633-3162
NPI assigned
Sep 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11028235 FL Primary

Addresses

Primary practice location

390 N Courtenay Pkwy
Merritt Island, FL 32953-3456

Mailing address

2890 Night Heron Dr
Mims, FL 32754-6507
Phone (321) 848-6383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231025003459 FL Practitioner - Nurse Practitioner 4981050077 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11028235FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medfast Urgent Care Centers LLC CurrentSince Aug 1, 2023 Accepting new patients
Medfast Urgent Care Centers, LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

390 N Courtenay Pkwy
Merritt Island, FL 32953
Phone (321) 633-3162

5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1972383891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 NIGHT HERON DR",
            "city": "MIMS",
            "state": "FL",
            "postal_code": "327546507",
            "telephone_number": "321-848-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533456",
            "telephone_number": "321-633-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "SUSAN",
        "credential": "MSN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11028235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.