Individual provider Active NPI

Susan Winstead Clarke, FNP

  • Family Nurse Practitioner
  • Morehead City, NC
National Provider Identifier
1972628600
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201333 Issued in NC
Practice address
221A Professional Cir
Morehead City, NC 28557-4303
Phone
(252) 726-5767
Fax
(252) 726-7573
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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 201333 NC Primary

Addresses

Primary practice location

221A Professional Cir
Morehead City, NC 28557-4303

Mailing address

221A Professional Cir
Morehead City, NC 28557-4303
Phone (252) 726-5767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090430000477 NC Practitioner - Nurse Practitioner 6901954999 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Coast Medical Center PC CurrentSince Jun 13, 2014 Accepting new patients

Locations

221A Professional Cir
Morehead City, NC 28557
Phone (252) 240-1765

Organizations & group practices 1

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1972628600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221A PROFESSIONAL CIR",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574303",
            "telephone_number": "252-726-5767",
            "fax_number": "252-726-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221A PROFESSIONAL CIR",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574303",
            "telephone_number": "252-726-5767",
            "fax_number": "252-726-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "SUSAN",
        "middle_name": "WINSTEAD",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

Verify at the official NPI Registry.