Active NPI
Susan B Tuttle, NP
- Nurse Practitioner
- Traverse City, MI
National Provider Identifier
1063635530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704123270
- Practice address
- 1221 6TH St
Suite 202
Traverse City, MI 49684-2359 - Phone
- (231) 935-5730
- Fax
- (231) 935-5736
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704123270 | MI | Primary |
Addresses
Primary practice location
1221 6TH St
Suite 202
Traverse City, MI 49684-2359
Mailing address
1221 6TH St
Suite 202
Traverse City, MI 49684-2359
Phone (231) 935-5730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704123270 | MI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063635530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 6TH ST",
"address_2": "SUITE 202",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842359",
"telephone_number": "231-935-5730",
"fax_number": "231-935-5736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 6TH ST",
"address_2": "SUITE 202",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842359",
"telephone_number": "231-935-5730",
"fax_number": "231-935-5736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUTTLE",
"first_name": "SUSAN",
"middle_name": "B",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704123270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.