Individual provider Active NPI

Susan Marie Croner, NP-BC

  • Nurse Practitioner
  • Dyer, IN
National Provider Identifier
1235240854
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71001197A Issued in IN
Practice address
2150 Gettler St Ste 400
Dyer, IN 46311-2385
Phone
(219) 865-0893
Fax
(219) 865-3599
NPI assigned
Aug 31, 2006
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71001197A IN Primary

Addresses

Primary practice location

2150 Gettler St Ste 400
Dyer, IN 46311-2385

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other identifiers 2

IdentifierTypeStateIssuer
200515670MedicaidIN
P00212275OtherRAILROAD MEDICARE

Other names 1

  • Susan M Bakker-Croner Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address scroner68103@Direct.FranciscanAlliance.org Direct

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71001197AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiospecialists Group, LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: scroner68103@direct.franciscanalliance.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1235240854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 GETTLER ST STE 400",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463112385",
            "telephone_number": "219-865-0893",
            "fax_number": "219-865-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONER",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001197A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200515670",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00212275",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scroner68103@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2150 Gettler St Ste 400",
            "city": "Dyer",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463112385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BAKKER-CRONER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dyer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.