Individual provider Active NPI

Susan Mae Zdun, RN, MS

  • Community Health Registered Nurse
  • Dallas, OR
National Provider Identifier
1245483593
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
086006546RN Issued in OR
Practice address
182 SW Academy St
Suite 302
Dallas, OR 97338-1922
Phone
(503) 623-8176
Fax
(503) 831-3499
NPI assigned
Oct 30, 2008
Last updated
Dec 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 086006546RN OR Primary

Addresses

Primary practice location

182 SW Academy St
Suite 302
Dallas, OR 97338-1922

Mailing address

182 SW Academy St
Suite 302
Dallas, OR 97338-1922
Phone (503) 623-8176

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
Credentials
Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
086006546RNORMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1245483593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 SW ACADEMY ST",
            "address_2": "SUITE 302",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381922",
            "telephone_number": "503-623-8176",
            "fax_number": "503-831-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 SW ACADEMY ST",
            "address_2": "SUITE 302",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381922",
            "telephone_number": "503-623-8176",
            "fax_number": "503-831-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDUN",
        "first_name": "SUSAN",
        "middle_name": "MAE",
        "credential": "RN, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "OR",
            "license": "086006546RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.