Active NPI
Susan E Stedje, MD
- Family Medicine Physician
- Kettering, OH
National Provider Identifier
1215914247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35055621
- Practice address
- 2501 S Dixie Dr
Kettering, OH 45409-1523 - Phone
- (937) 643-3083
- Fax
- (937) 643-3089
- NPI assigned
- Dec 30, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35055621 | OH | Primary |
Addresses
Primary practice location
2501 S Dixie Dr
Kettering, OH 45409-1523
Mailing address
4000 Miamisburg Centerville Rd Ste 410
Miamisburg, OH 45342-3758
Phone (937) 384-8773
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0740836 | Medicaid | OH |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | sstedje203168@direct.ketteringhealth.org |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1215914247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 MIAMISBURG CENTERVILLE RD STE 410",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453423758",
"telephone_number": "937-384-8773",
"fax_number": "937-384-0794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 S DIXIE DR",
"city": "KETTERING",
"state": "OH",
"postal_code": "454091523",
"telephone_number": "937-643-3083",
"fax_number": "937-643-3089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEDJE",
"first_name": "SUSAN",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-30",
"last_updated": "2020-11-19",
"certification_date": "2020-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35055621",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0740836",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "4000 Miamisburg Centerville Rd Ste 410",
"city": "Miamisburg",
"state": "OH",
"country_code": "US",
"postal_code": "453423758",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sstedje203168@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "4000 Miamisburg Centerville Rd Ste 410",
"city": "Miamisburg",
"state": "OH",
"country_code": "US",
"postal_code": "453423758",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kettering, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.