DR. SUSAN J VAN FOSSEN (NPI# 1558309328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558309328 |
| Entity Type | Individual |
| Full Name | DR. SUSAN J VAN FOSSEN |
| Credential | RN, MSN, BC, PMHNP, |
| Practice Address |
616 W Russell Pl San Antonio TX 78212-3658 |
| Mailing Address |
1105 Cliff Swallow Dr Granbury TX 76048-2651 |
| Practice Telephone | 8002578715 |
| Practice Fax Number | 8008191655 |
| Mailing Telephone | 8175796757 |
| Mailing Fax Number | 8008191655 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2010-02-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
232874 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 118282603 | 05 | |
| TX | 118282601 | 05 | |
| TX | 118282602 | 05 | |
| TX | BLUE CROSS BLUE SHIELD | 87N290 | 01 |
| TX | BLUE CROSS BLUE SHIELD | 8N3327 | 01 |
| TX | INDIVIDUAL | 118282605 | 01 |
| TX | RAILROAD | 500012787 | 01 |
| Street Address |
616 W RUSSELL PL |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78212-3658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902843808 | Vija Ziemelis Mcdill | Psychologist | 616 W Russell Pl, San Antonio, TX 78212-3658 | 2006-05-31 |
| 1396073474 | Rj Meridian Care Alta Vista LLC | Skilled Nursing Facility | 616 W Russell Pl, San Antonio, TX 78212-3658 | 2009-11-30 |
| 1356524391 | Elizabeth A Keller | Nurse Practitioner | 616 W Russell Pl, San Antonio, TX 78212-3658 | 2007-12-13 |
| 1093832065 | Robert G. Braun | Psychologist | 616 W Russell Pl, San Antonio, TX 78212-3658 | 2007-03-23 |
| 1821113937 | James L. Stringer | Social Worker | 616 W Russell Pl, San Antonio, TX 78212-3658 | 2007-03-20 |
| 1124159199 | Richard B. Kilgore | Psychologist | 616 W Russell Pl, San Antonio, TX 78212-3658 | 2007-03-08 |
| 1184761207 | Nicholas V. Camperlengo | Psychiatry & Neurology | 616 W Russell Pl, San Antonio, TX 78212-3658 | 2007-01-30 |
| 1134275076 | Nancy C. Davenport | Clinical Nurse Specialist | 616 W Russell Pl, San Antonio, TX 78212-3658 | 2007-01-25 |
| 1194878488 | Lucy Arias-ricketts | Social Worker | 616 W Russell Pl, San Antonio, TX 78212-3658 | 2007-01-19 |
| 1003967555 | Janet E. Frakes | Social Worker | 616 W Russell Pl, San Antonio, TX 78212-3658 | 2007-01-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902451701 | Ninfa Hernandez Guzman | Assisted Living Facility | 325 E Locust St., San Antonio, TX 78212 | 2019-08-08 |
| 1366924730 | David Edward Dupuy | Occupational Therapist | 307 West Cypress, San Antonio, TX 78212 | 2018-09-03 |
| 1184100836 | Magenta Health, Inc. | Clinic/Center | 1222 North Main, Suite 115, San Antonio, TX 78212 | 2018-07-16 |
| 1497275762 | Dms Pharmacy, LLC | Pharmacy | 305 East Euclid, Suite 104, San Antonio, TX 78212 | 2017-06-27 |
| 1245693290 | Rebecca Lynn Sherman | Physical Therapist | 40 Ne Interstate 410 Loop, San Antonio, TX 78212 | 2016-03-29 |
| 1669886032 | Felise De Novo, PC | Counselor | 2400 Mccullough Ave., #12851, San Antonio, TX 78212 | 2014-06-13 |
| 1699102699 | Prem S. Kalidindi | Pharmacist | 2608 N. Main, Ste 1, San Antonio, TX 78212 | 2013-10-04 |
| 1073860052 | Sarah Nicole Percy Tovar | Dentist | 4118 Mccullough Ave., Suite 6, San Antonio, TX 78212 | 2012-08-09 |
| 1205181674 | Michael Jose Cavazos | Internal Medicine | 1100 Mccullough Ave Ste 300, San Antonio, TX 78212 | 2012-07-20 |
| 1730458381 | Neuriom, Pllc | Electrodiagnostic Medicine | 4007 Mccullough Ave, #243, San Antonio, TX 78212 | 2011-12-27 |
| Find all providers in zip 78212 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225643968 | Britanni O Greene | Nurse Practitioner | 10650 Culebra Rd # 104-548, San Antonio, TX 78251-4949 | 2020-09-10 |
| 1356955462 | Saeid Nekoueian | Nurse Practitioner | 19506 Flair Oak, San Antonio, TX 78258-3648 | 2020-09-04 |
| 1649806282 | Monique Straker | Nurse Practitioner | 9480 Huebner Rd Ste 210, San Antonio, TX 78240-1657 | 2020-03-16 |
| 1245864396 | Jordan Nichole Davis | Nurse Practitioner | 7035 Pickwell Dr Apt 2100, San Antonio, TX 78223-3385 | 2020-02-27 |
| 1447714274 | Suzanne Perakathu | Nurse Practitioner | 7122 Stonewall Hill, San Antonio, TX 78256 | 2019-01-25 |
| 1023536612 | Olena Shvets | Nurse Practitioner | 311 Camden St # 510, San Antonio, TX 78215-2012 | 2017-09-02 |
| 1528598620 | Dianne Lavin LLC | Nurse Practitioner | 503 Benedict Ct, San Antonio, TX 78258-2545 | 2017-06-13 |
| 1699215293 | Monique Gonzalez | Nurse Practitioner | 311 Camden St., Suite 510, San Antonio, TX 78215 | 2017-03-01 |
| 1215476940 | Vita T Chung | Nurse Practitioner | 8122 Datapoint Dr Ste 1000, San Antonio, TX 78229-3273 | 2017-02-14 |
| 1629512926 | Mark Evans | Nurse Practitioner | 311 Camden St Ste 606, San Antonio, TX 78215-2016 | 2016-12-06 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78212 |
Please comment or provide details below to improve the information on DR. SUSAN J VAN FOSSEN.
| 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.