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SUSAN KELLY BLUE M.D. NPI 1578540431


NPI Information

NPI: 1578540431
Provider Name: SUSAN KELLY BLUE, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1001 WASHINGTON AVE
FORT WORTH, TX
ZIP 76104
Phone: (817) 334-7922
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Susan Kelly Blue, M.D. is a specialist in Fort Worth, TX with 55 years of experience. The provider is 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. Susan Kelly Blue, M.D. NPI is 1578540431. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1969

The provider's business location address is:

1001 WASHINGTON AVE
FORT WORTH, TX
ZIP 76104-049
Phone: (817) 334-7922
Fax: (817) 870-2144

The NPI 1578540431 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Needle measurement and recording of electrical activity of muscles of arm or leg complete study (HCPCS:95886)
  • Nerve transmission studies, 7-8 studies (HCPCS:95910)
  • Measurement and recording of brain wave (eeg) activity, awake and asleep (HCPCS:95819)

The enumeration date for this NPI number is 12/30/2005 and was last updated on 5/11/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistE1506TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.