Individual provider Active NPI

Susan C Nordquist, NP

  • Family Nurse Practitioner
  • West Fargo, ND
National Provider Identifier
1023164845
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R25010 Issued in ND
Practice address
505 32ND Ave E Ste B
West Fargo, ND 58078-8490
Phone
(701) 532-1731
Fax
(701) 532-1940
NPI assigned
Jan 26, 2007
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R25010 ND Primary

Addresses

Primary practice location

505 32ND Ave E Ste B
West Fargo, ND 58078-8490

Mailing address

505 32ND Ave E Ste B
West Fargo, ND 58078-8490
Phone (701) 532-1731

Other identifiers 1

IdentifierTypeStateIssuer
1023164845MedicaidMN

Other names 1

  • Susan C Upton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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

Enrollment IDStateProvider typePAC IDDetails
I20070523000184 ND Practitioner - Nurse Practitioner 3274630454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenient Care Clinic PLLCGroup PAC ID 5193184794, 3 clinicians

Practice addresses (Care Compare)

505 32ND Ave E
Suite B
West Fargo, ND 58078-8490
Phone (701) 532-1731

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
593MNMDMental Health Counselor
R25010NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Convenient Care Clinic, PLLC Family CurrentSince May 2, 2023 Accepting new patients
Convenient Care Clinic, PLLC Current Accepting new patients
CPN Network LLC PastSince Apr 5, 2025 Accepting new patients

Locations

3306 Sheyenne St
Ste 216
West Fargo, ND 58078
Phone (701) 532-1731

505 32nd Ave E
Ste B
West Fargo, ND 58078
Phone (701) 532-1731

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1023164845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 32ND AVE E STE B",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788490",
            "telephone_number": "701-532-1731",
            "fax_number": "701-532-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 32ND AVE E STE B",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788490",
            "telephone_number": "701-532-1731",
            "fax_number": "701-532-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDQUIST",
        "first_name": "SUSAN",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R25010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023164845",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "UPTON",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Fargo, ND

Sources for this page

Verify at the official NPI Registry.