Individual provider Active NPI

Susan E Piecynski, ACNP

  • Acute Care Nurse Practitioner
  • Zanesville, OH
National Provider Identifier
1063721389
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
12019-NP Issued in OH
Practice address
751 Forest Ave
Suite 200
Zanesville, OH 43701-2868
Phone
(740) 455-7670
NPI assigned
Oct 4, 2010
Last updated
Jul 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 12019-NP OH Primary
Registered Nurse 163W00000X 364523 OH

Addresses

Primary practice location

751 Forest Ave
Suite 200
Zanesville, OH 43701-2868

Mailing address

10380 Pidcock Rd
Norwich, OH 43767-9735
Phone (256) 797-8167

Other names 1

  • Susan M Ecklin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20110421000905 OH Practitioner - Nurse Practitioner 0648455329 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
364523OHMDRegistered Nurse
12019-NPOHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group LLC Current Accepting new patients
Genesis Medical Group, LLC CurrentSince Mar 8, 2011 Accepting new patients
Genesis Medical Group, LLC CurrentSince Mar 8, 2011 Accepting new patients

Locations

2916 Vangader Dr
Zanesville, OH 43701
Phone (740) 453-0661

751 Forest Ave
Ste 200
Zanesville, OH 43701
Phone (740) 453-0548

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

945 Bethesda Dr
Ste 260
Zanesville, OH 43701
Phone (740) 450-4180

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

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.

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1063721389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10380 PIDCOCK RD",
            "city": "NORWICH",
            "state": "OH",
            "postal_code": "437679735",
            "telephone_number": "256-797-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 FOREST AVE",
            "address_2": "SUITE 200",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012868",
            "telephone_number": "740-455-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIECYNSKI",
        "first_name": "SUSAN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "12019-NP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "364523",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "ECKLIN",
            "middle_name": "M",
            "credential": "ACNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.