Individual provider Active NPI

Susan Yetter

  • Registered Nurse
  • Chippewa Falls, WI
National Provider Identifier
1184459109
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
125497-30 Issued in WI
Practice address
13724 84TH Ave
Chippewa Falls, WI 54729-8840
Phone
(715) 828-9849
NPI assigned
Sep 9, 2024
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 125497-30 WI Primary

Addresses

Primary practice location

13724 84TH Ave
Chippewa Falls, WI 54729-8840

Mailing address

13724 84TH Ave
Chippewa Falls, WI 54729-8840
Phone (715) 828-9849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
125497-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1184459109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13724 84TH AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547298840",
            "telephone_number": "715-828-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13724 84TH AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547298840",
            "telephone_number": "715-828-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YETTER",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "125497-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.