Individual provider Active NPI

Susan V. Schloss, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1114452141
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024166201 Issued in VA
Practice address
3960 Virginia Beach Blvd
Virginia Beach, VA 23452-2449
Phone
(757) 668-4648
Fax
(757) 668-4944
NPI assigned
Apr 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024166201 VA Primary

Addresses

Primary practice location

3960 Virginia Beach Blvd
Virginia Beach, VA 23452-2449

Mailing address

3960 Virginia Beach Blvd
Virginia Beach, VA 23452-2449
Phone (757) 668-4648

Other practice location 1

680 Oyster Point Rd
Newport News, VA 23606-4570
Phone (757) 668-4851

Other practice location 2

817 Volvo Pkwy
Chesapeake, VA 23320-2855
Phone (757) 668-4630

Other names 1

  • Susan Diane Van Slyke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20171106003232 VA Practitioner - Nurse Practitioner 8628062130 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1114452141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234522449",
            "telephone_number": "757-668-4648",
            "fax_number": "757-668-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234522449",
            "telephone_number": "757-668-4648",
            "fax_number": "757-668-4944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Oyster Point Rd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064570",
            "country_code": "US",
            "telephone_number": "757-668-4851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "817 Volvo Pkwy",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233202855",
            "country_code": "US",
            "telephone_number": "757-668-4630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHLOSS",
        "first_name": "SUSAN",
        "middle_name": "V.",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024166201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "VAN SLYKE",
            "middle_name": "DIANE",
            "credential": "C.P.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.