Susan Lynn Persson, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003766 Issued in MI

Practice address

7 Atkinson Dr Ste 111
Ludington, MI 49431-1953

Phone

(231) 843-3487

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BHBADA/Endpoint/BHBADA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Memorial Medical Center of West Michigan

  • General Acute Care Hospital
  • Ludington, MI
  • NPI 1972589489
  Medicare reassignment NPD
• Michigan Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Brighton, MI
  • NPI 1669901567
  Medicare reassignment
• CS Pacs 3 Midwest LLC

  • Hospitalist Physician
  • Dayton, OH
  • NPI 1972368785

  MI

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498694400000",
    "number": "1003996984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ATKINSON DR STE 111",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311953",
            "telephone_number": "231-843-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSSON",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2017-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pere Marquette Emergency Physicians, PLC
• Pere Marquette Medical Imaging PC
• Deanna Persoon, LMSW
• Justin Persoon, MA
• Persson Internal Medicine,P.C
• Brenden Peterson
• Carol E Peterson, M.D.
• Kaylin Petzak, PHARM.D.
• Kylie Petzak, RN
• Michelle Piwowarski, PT, DPT

• Physician Assistant in Ludington, MI
• Providers in Ludington, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.