SUSAN RAE AULT (NPI# 1790777100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790777100 |
| Entity Type | Individual |
| Full Name | SUSAN RAE AULT |
| Credential | FNP |
| Practice Address |
2830 East St Anderson CA 96007-3408 |
| Practice Telephone | 5303652545 |
| Practice Fax Number | 5303653871 |
| Mailing Telephone | 5303652545 |
| Mailing Fax Number | 5303653871 |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2016-05-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WG0000X |
Registered Nurse Specialization: General Practice |
083045668RN | OR | Nursing Service Providers |
| N | 363L00000X | Nurse Practitioner | 200450018NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
14768 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SX0200X |
Clinical Nurse Specialist Specialization: Oncology |
200570025CNS | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | GROUP NPI NUMBER | 1407812365 | 01 |
| OR | MEDICARE GROUP PIN NUMBER | R0000WFBTV | 01 |
| OR | 278215 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376889626 | Susan Elizabth Ault | Occupational Therapy Assistant | 12346 Rossridge Ct, Saint Louis, MO 63146-4607 | 2012-12-13 |
| 1013442706 | Susan Ault | Licensed Practical Nurse | 1 Halloran Park Ln, Saint Clairsville, OH 43950-1367 | 2017-05-01 |
| 1154634434 | Susan Ault | Pharmacist | 8040 Mesa Dr, Austin, TX 78731-1319 | 2010-07-15 |
| 1528271103 | Susan Eliane Ault | Nurse Practitioner | 707 N Armstrong Pl, Boise, ID 83704-0825 | 2007-05-08 |
| Street Address |
2830 EAST ST |
| City | ANDERSON |
| State | CA |
| Zip Code | 96007-3408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700137882 | Roberta Ann Samples | Registered Nurse | 2830 East St, Anderson, CA 96007 | 2012-09-28 |
| 1679839138 | William David Blackmon | Nurse Practitioner | 2830 East St, Anderson, CA 96007-3408 | 2012-04-09 |
| 1457405920 | Anderson Medical Associates | Family Medicine | 2830 East St, Anderson, CA 96007-3408 | 2007-01-22 |
| 1851373534 | Nirmal Singh Mehton | Family Medicine | 2830 East St, Anderson, CA 96007-3408 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780948497 | Marilee Ruth King | Veterinarian | 3100 W Center St, Anderson, CA 96007 | 2012-06-27 |
| 1881821064 | William Martin Reuss Iv | Dentist | 1930 North Barney St., Anderson, CA 96007 | 2009-06-16 |
| 1063676898 | Adriana Elia Vazquez | Licensed Vocational Nurse | 7175 Eastsidee Rd, Anderson, CA 96007 | 2008-07-10 |
| 1730211103 | Danene Renee Mercill | Dentist | 2817 Childress Rd, Anderson, CA 96007 | 2007-03-12 |
| 1750457388 | Debra Marie Wright | Family Medicine | 2830 East Street, Anderson, CA 96007 | 2006-11-27 |
| 1346315538 | Susan Frances Capella | Occupational Therapist | 3300 Franklin St, Anderson, CA 96007 | 2006-11-22 |
| 1205917127 | Walmart Stores, Inc. | Technician/Technologist | 5000 Rhonda Road, Anderson, CA 96007 | 2006-10-18 |
| 1063527372 | Steven Edward Ahrens | Dentist | 1901 Barney Rd, Anderson, CA 96007 | 2006-08-20 |
| 1255340568 | Paul C Davainis | Family Medicine | 2965 East St, Anderson, CA 96007 | 2006-08-05 |
| 1972803443 | Michael Harris | Pharmacist | 2601 Balls Ferry Rd, Anderson, CA 96007 | 2010-10-29 |
| Find all providers in zip 96007 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407462773 | Ashley Nicole Jones | Nurse Practitioner | 5226 Fletcher St, Anderson, IN 46013-4819 | 2020-09-21 |
| 1689285538 | Austin Darbyshire | Nurse Practitioner | 215 Fox Trl, Anderson, SC 29621-4417 | 2020-08-13 |
| 1326517194 | Ashlea Bronwen Bates | Nurse Practitioner | 3424 Clemson Blvd., Anderson, SC 29621 | 2018-11-21 |
| 1558871681 | His Solutions Specialty Care Corp. | Nurse Practitioner | 33 W 10th St #621, Anderson, IN 46016-1493 | 2017-10-03 |
| 1760939110 | Crystal Vaughn | Nurse Practitioner | Sac Anmed Health 2000 East Greenville Street, Anderson, SC 29621 | 2016-09-01 |
| 1316318454 | Donna Gibson Marcengill | Nurse Practitioner | 2000 E Greenville St Ste 2000, Anderson, SC 29621-1720 | 2015-10-15 |
| 1750763405 | Holly D. Rogers | Nurse Practitioner | 800 N Fant St., Anderson, SC 29621 | 2015-06-18 |
| 1093019952 | Susan Lee Sanders | Nurse Practitioner | 2017 Norwood Dr, Anderson, IN 46012-1832 | 2011-01-06 |
| 1184931081 | Tracey Glen Schofield Jr. | Nurse Practitioner | 2000 E Greenville St Ste 2800, Anderson, SC 29621-1722 | 2010-09-13 |
| 1073755658 | Jenile J Abell | Nurse Practitioner | 1210 Medical Arts Blvd Ste 206, Anderson, IN 46011-3437 | 2009-03-30 |
| Find all providers in ANDERSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.