Active NPI
Susan Short, CRNP
- Acute Care Nurse Practitioner
- Birmingham, AL
National Provider Identifier
1992811152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 1035474
- Practice address
- 817 Princeton Ave SW
Ste 115
Birmingham, AL 35211-1333 - Phone
- (205) 780-1963
- Fax
- (205) 780-1967
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 1035474 | AL | Primary |
Addresses
Primary practice location
817 Princeton Ave SW
Ste 115
Birmingham, AL 35211-1333
Mailing address
817 Princeton Ave SW
Ste 115
Birmingham, AL 35211-1333
Phone (205) 780-1963
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51504287 | Other | AL | BLUE CROSS OF AL |
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
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1035474 | AL | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184371200000",
"number": "1992811152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 PRINCETON AVE SW",
"address_2": "STE 115",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352111333",
"telephone_number": "205-780-1963",
"fax_number": "205-780-1967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "817 PRINCETON AVE SW",
"address_2": "STE 115",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352111333",
"telephone_number": "205-780-1963",
"fax_number": "205-780-1967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORT",
"first_name": "SUSAN",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "AL",
"license": "1035474",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF AL",
"identifier": "51504287",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.