SUSIE A JOHN (NPI# 1194714956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194714956 |
| Entity Type | Individual |
| Full Name | SUSIE A JOHN |
| Credential | MD MPH |
| Practice Address |
Us Hwy 491 North Shiprock NM 87420 |
| Mailing Address |
Po Box 160 Shiprock NM 87420-0160 |
| Practice Telephone | 5053686401 |
| Practice Fax Number | 5053686431 |
| Mailing Telephone | 5053686401 |
| Mailing Fax Number | 5053686431 |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2007-12-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
85216 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 939572 | 05 | |
| NM | 35568 | 05 | |
| CO | 30487064 | 05 |
| Street Address |
US HWY 491 NORTH |
| City | SHIPROCK |
| State | NM |
| Zip Code | 87420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285636191 | Jason Boyd Girouard | Nurse Anesthetist, Certified Registered | Us Hwy 491 North, Shiprock, NM 87420 | 2005-08-10 |
| 1215550843 | Kaitlin A Philipsen | Optometrist | Us Hwy 491 North, Shiprock, NM 87420 | 2020-05-18 |
| 1417517533 | Ethan Fahrney | Occupational Therapist | Us Hwy 491 North, Shiprock, NM 87420 | 2019-06-20 |
| 1124687884 | Kia Yang | Optometrist | Us Hwy 491 North, Shiprock, NM 87420 | 2019-06-06 |
| 1700346095 | Laura Bodnar | Pharmacist | Us Hwy 491 North, Shiprock, NM 87420 | 2019-03-22 |
| 1275006116 | Billie Don Evans IIi | Pharmacist | Us Hwy 491 North, Shiprock, NM 87420 | 2019-01-03 |
| 1093287609 | Ivan Teodoro Chia | Registered Nurse | Us Hwy 491 North, Shiprock, NM 87420-0160 | 2018-12-20 |
| 1467944041 | Elysia Ison | Optometrist | Us Hwy 491 North, Shiprock, NM 87420 | 2018-05-31 |
| 1407343809 | Pamela Bryan | Social Worker | Us Hwy 491 North, Shiprock, NM 87420 | 2018-04-20 |
| 1164919304 | Jerren Michael Alcalde | Dentist | Us Hwy 491 North, Shiprock, NM 87420 | 2018-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003424383 | Ciara Hansen | Psychologist | Us- 491, Shiprock, NM 87420 | 2020-07-22 |
| 1013540848 | Kelsi Marie Hartwig | Dental Hygienist | Highway 491 North, Yucca Street, Shiprock, NM 87420 | 2020-02-20 |
| 1194364232 | Maria Sturtz | Pharmacist | Us Why 491 North, Shiprock, NM 87420 | 2020-01-06 |
| 1811533979 | Merissa Jo De La Garza | Pharmacist | Highway 491 S, Shiprock, NM 87420 | 2019-11-25 |
| 1619528510 | Heather Scott | Psychologist | Highway 64, Old High School Road, Shiprock, NM 87420 | 2019-09-23 |
| 1396305264 | Malaura Creager | Pharmacist | North Hwy 491, Shiprock, NM 87420 | 2019-06-13 |
| 1275011488 | Dawn Fowler | Registered Nurse | Us Highway 64, Shiprock, NM 87420 | 2018-07-31 |
| 1902384373 | Brittany Jones | Occupational Therapy Assistant | Us 64, Old High School Rd., Shiprock, NM 87420 | 2018-07-30 |
| 1528561701 | Patricia D Suarez | Registered Nurse | Central Consolidated School of New Mexico, Hwy 64, Old High School Road, Shiprock, NM 87420 | 2018-03-14 |
| 1023549284 | Ellen Liversidge | Speech-Language Pathologist | Hwy 64, Old High School Rd., Shiprock, NM 87420 | 2017-03-21 |
| Find all providers in zip 87420 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922013499 | Jane Mcgrath | Pediatrics | 625 Silver Ave Sw Ste 324, Albuquerque, NM 87102-3184 | 2006-07-30 |
| 1952316416 | Victor C Strasburger | Pediatrics | Dept Pediatrics 3rd Floor Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-07-30 |
| 1215900766 | Michael Parrino | Pediatrics | 905 S 8th St Ste B, Deming, NM 88030-4037 | 2006-02-07 |
| 1801165162 | Patsy Andrada | Pediatrics | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2745 | 2011-12-15 |
| 1124233903 | Allan L. Paul M.d., PC | Pediatrics | 2559 Medical Dr, Ste E, Alamogordo, NM 88310-8703 | 2007-05-14 |
| 1720109358 | Pediatric Health Services PC | Pediatrics | 10110 Spain Rd Ne, Albuquerque, NM 87111-1965 | 2007-04-02 |
| 1457367047 | Susan Root | Pediatrics | 3rd Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-08-01 |
| 1922013481 | Carol Clericuzio | Pediatrics | 2211 Lomas Blvd Ne, Msc10 5590, Albuquerque, NM 87131-0001 | 2006-07-30 |
| 1821003385 | Alberta Kong | Pediatrics | 3rd Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-07-30 |
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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.