Susan Eileen Bailey, CNP
Individual provider Active NPI Family Nurse Practitioner · Fort Wayne, IN
NPI 1124540455 · NPPES record last updated Sep 17, 2025
Key facts
- NPI
- 1124540455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71007587A (IN)
- Practice address
- 3005 E State Blvd
Fort Wayne, IN 46805-4736 - Phone
- (260) 267-9498
- NPI assigned
- Jul 7, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cleanslate Medical Group of Indiana LLC
Practice addresses (Care Compare)
3005 E State Blvd
Fort Wayne, IN 46805-4736
Phone (260) 267-9498
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.53 of 100
- Quality
- 70
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.11
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171130001527 | IN | Practitioner - Nurse Practitioner | 4789941634 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71007587A | IN | MD | Family Nurse Practitioner |
| APRN.CNP.0038282 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Partners of Western Ohio | Current | Accepting new patients | |
| Cleanslate Medical Group of Indiana LLC | Current |
Accepting new patients | |
| Cleanslate Medical Group of Pennsylvania LLC | Past |
Accepting new patients |
Locations
101 N Harrison St
Alexandria, IN 46001
Phone (765) 233-0903
4925 S Scatterfield Rd
Anderson, IN 46013
Phone (765) 442-0402
4925 S Scatterfield Rd
#G
Anderson, IN 46013
Phone (765) 442-0402
203 W 1st St
Bloomington, IN 47403
Phone (812) 339-1675
1004 Parkway Ave
Ste E
Elkhart, IN 46516
Phone (574) 218-7131
4411 Washington Ave
Ste 105
Evansville, IN 47714
Phone (812) 213-0304
3005 E State Blvd
Fort Wayne, IN 46805
Phone (260) 267-9498
833 Indianapolis Rd
Ste E
Greencastle, IN 46135
Phone (765) 301-3680
65 Airport Pkwy
Ste 114
Greenwood, IN 46143
Phone (317) 807-0268
1725 N Meridian St
Indianapolis, IN 46202
Phone (317) 396-1676
9660 E Washington St
#300
Indianapolis, IN 46229
Phone (317) 860-5600
3728 S Reed Rd
Kokomo, IN 46902
Phone (765) 626-7110
30 Professional Ct
Ste 2
Lafayette, IN 47905
Phone (765) 838-1218
8601 Connecticut St
Merrillville, IN 46410
Phone (219) 525-3495
124 E Main St
Muncie, IN 47305
Phone (765) 587-7311
18051 River Rd
Ste 101
Noblesville, IN 46062
Phone (317) 674-0062
2455 E Main St
#194
Plainfield, IN 46168
Phone (317) 268-7198
2302 Chester Blvd
Ste A
Richmond, IN 47374
Phone (765) 488-0345
2936 Frontage Rd
Warsaw, IN 46580
Phone (574) 306-2145
228 S Main St
Bryan, OH 43506
Phone (567) 239-4562
329 N West St
Lima, OH 45801
Phone (419) 229-6007
1 Spartan Way
Lima, OH 45801
Phone (419) 222-3546
8 Cadillac Dr
Ste 300
Brentwood, TN 37027
Phone (615) 944-0212
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.0038282 | OH | |
| Family Nurse Practitioner | 363LF0000X | 71007587A | IN | Yes |
Addresses
Primary practice location
3005 E State Blvd
Fort Wayne, IN 46805-4736
Mailing address
3005 E State Blvd
Fort Wayne, IN 46805-4736
Phone (260) 267-9498
Other providers in Fort Wayne, IN
- Kimberly Ann Bailey
- Kylie Mackenzie Bailey
- Michelle A Bailey
- Shalynn Grace Bailey
- Stephen Bryan Bailey
- Urian Bailey
- Heather Bain
- Cheryl Lynn Bair
- Jasmyn Nicole Bair
- Michael E Bair
All providers in Fort Wayne, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.