SUSAN KELLY BLUE (NPI# 1578540431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578540431 |
| Entity Type | Individual |
| Full Name | SUSAN KELLY BLUE |
| Credential | M.D. |
| Practice Address |
1001 Washington Ave Fort Worth TX 76104-3049 |
| Practice Telephone | 8173347922 |
| Practice Fax Number | 8178702144 |
| Mailing Telephone | 8173347922 |
| Mailing Fax Number | 8178702144 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2011-05-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | E1506 | TX | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366522195 | Susan W. Blue | Psychologist | 804 Valley Plz, Johnson City, NY 13790-1009 | 2006-10-16 |
| 1760551089 | Susan Diane Blue | Physical Therapist | 275 Century Cir, Suite 103, Louisville, CO 80027-9729 | 2006-11-08 |
| 1265543839 | Susan M Blue | Nurse Practitioner | 1330 Rockefeller Ave, Suite 310, Everett, WA 98201-1684 | 2006-08-31 |
| Street Address |
1001 WASHINGTON AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-3049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285822775 | Neurological Services of Texas, P.a. | Specialist | 1001 Washington Ave, Fort Worth, TX 76104-3021 | 2007-10-09 |
| 1184651010 | Norris Duane Purcell | Psychiatry & Neurology | 1001 Washington Ave, Fort Worth, TX 76104 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093334039 | Sport Is Religion | Specialist | 8641 Las Vegas Ct Apt 2722, Fort Worth, TX 76116-0044 | 2020-04-09 |
| 1518471986 | Tyrin W Holt | Specialist | 1540 Berckmans Rd, Fort Worth, TX 76120-1500 | 2017-11-21 |
| 1538567151 | Sarah Dimarco | Specialist | 3704 Staghorn Cir N, Fort Worth, TX 76137-6054 | 2014-12-13 |
| 1639581077 | Pre Diabetes Physician Services Inc | Specialist | 1307 8th Ave Ste 502, Fort Worth, TX 76104-4137 | 2014-05-20 |
| 1447661509 | Veronica C Zapata | Specialist | 1113 Nw 25th St, Fort Worth, TX 76164-6904 | 2014-05-12 |
| 1962835439 | Sara Syeda | Specialist | 7250 Hawkins View Dr Ste 410, Fort Worth, TX 76132-3932 | 2013-08-19 |
| 1750624417 | Jennifer C. Brooks, Md Pllc | Specialist | 909 9th Ave Ste 101, Fort Worth, TX 76104-3916 | 2013-04-01 |
| 1063766178 | Richard Eugene Smith | Specialist | 7162 Axis Ct, Fort Worth, TX 76132-3573 | 2012-10-29 |
| 1770831463 | Sharon A Guillory | Specialist | 5441 S Hulen Street, Dona's Wigs, Fort Worth, TX 76132 | 2012-08-28 |
| 1740537281 | Chu Eye Institute, P.a. | Specialist | 3017 W 7th St # 210, Fort Worth, TX 76107-2223 | 2012-08-14 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on SUSAN KELLY BLUE.
| 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.