NPIMap

Individual provider Active NPI

Susan Elizabeth Dornan, CNM

  • Advanced Practice Midwife
  • Westlake, OH
National Provider Identifier
1215986955
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
NM07751 Issued in OH
Practice address
29160 Center Ridge Rd
Suite M
Westlake, OH 44145-5225
Phone
(440) 835-6996
Fax
(440) 808-9738
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X NM07751 OH Primary

Addresses

Primary practice location

29160 Center Ridge Rd
Suite M
Westlake, OH 44145-5225

Mailing address

26908 Detroit Rd
Suite 301
Westlake, OH 44145-2398
Phone (440) 617-1823

Other identifiers 4

IdentifierTypeStateIssuer
2601438MedicaidOH
341542312126OtherOHCARESOURCE
000000377270OtherOHANTHEM BC/BS
350112OtherOHWELLCARE

Other names 1

  • Susan Elizabeth Allen Former name

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
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
NM07751OHMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation Past Accepting new patients
Clinic Regional Physicians LLC Advanced Practice Midwife Past Accepting new patients
Lakewood Hospital Association Advanced Practice Midwife Past Accepting new patients
Lakewood Hospital Association Past Accepting new patients

Organizations & group practices 4

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1215986955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26908 DETROIT RD",
            "address_2": "SUITE 301",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452398",
            "telephone_number": "440-617-1823",
            "fax_number": "440-617-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29160 CENTER RIDGE RD",
            "address_2": "SUITE M",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455225",
            "telephone_number": "440-835-6996",
            "fax_number": "440-808-9738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNAN",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OH",
            "license": "NM07751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2601438",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341542312126",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000377270",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "350112",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "ALLEN",
            "middle_name": "ELIZABETH",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.