Individual provider Active NPI

Susan A. Wnuk, FNP

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1992751804
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP119468 Issued in TX
Practice address
4450 Medical Dr FL 1
San Antonio, TX 78229-3710
Phone
(210) 575-3817
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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 AP119468 TX
Nurse Practitioner 363L00000X AP119468 TX Primary

Addresses

Primary practice location

4450 Medical Dr FL 1
San Antonio, TX 78229-3710

Mailing address

1323 Crown BRK
San Antonio, TX 78260-2485
Phone (919) 454-4522

Other identifiers 1

IdentifierTypeStateIssuer
219609902MedicaidTX

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP119468TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Care Network of South Texas PA Nurse Practitioner Past Accepting new patients

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1992751804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 CROWN BRK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782602485",
            "telephone_number": "919-454-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 MEDICAL DR FL 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293710",
            "telephone_number": "210-575-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WNUK",
        "first_name": "SUSAN",
        "middle_name": "A.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP119468",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP119468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219609902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.