Individual provider Active NPI

Susan A Baltz, FNP

  • Family Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1992919484
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
251159 Issued in TX
Practice address
5211 W 9TH Ave
Amarillo, TX 79106-4120
Phone
(806) 731-1516
NPI assigned
May 10, 2007
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP107029 TX
Family Nurse Practitioner 363LF0000X 251159 TX Primary

Addresses

Primary practice location

5211 W 9TH Ave
Amarillo, TX 79106-4120

Mailing address

PO Box 1156
Canyon, TX 79015
Phone (806) 206-1494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20091203000257 TX Practitioner - Nurse Practitioner 1951374008 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FMC Palliative Care, LLCGroup PAC ID 6406268358, 8 clinicians

Practice addresses (Care Compare)

2501 Lakeview Dr
Amarillo, TX 79109-1531
Phone (806) 350-7325

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP107029TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FMC Long-Term Care, P.a. Family CurrentSince Aug 1, 2020 Accepting new patients
FMC Palliative Care, LLC Family CurrentSince Jan 30, 2023 Accepting new patients
Grand Medical Clinic Family PastSince Jan 1, 1999 Accepting new patients
FMC LTC Aco LLC Nurse Practitioner Past Accepting new patients

Locations

1616 S Kentucky St
Ste B100
Amarillo, TX 79102
Phone (806) 355-8900

2501 Lakeview Dr
Amarillo, TX 79109
Phone (806) 350-7325

5211 W 9th Ave
Amarillo, TX 79106
Phone (806) 350-8277

5211 W 9th Ave
Ste 140
Amarillo, TX 79106
Phone (806) 352-5911

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1992919484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1156",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "79015",
            "telephone_number": "806-206-1494",
            "fax_number": "806-731-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 W 9TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791064120",
            "telephone_number": "806-731-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTZ",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP107029",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "251159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.