Susan Ellen Beck, C.P.N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704219112 Issued in MI

Practice address

1310 Greenwood Ave
Jackson, MI 49203-3077

Phone

(517) 962-0123

Fax

(517) 201-8067

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sbeck443325@direct.hfhs.org
• FHIR API: https://api.platform.athenahealth.com/15084/brand/2/csg/1/fhir/r4

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.

• Lenae E Vanwagnen MD LLC

  • Pediatrics Physician
  • Jackson, MI
  • NPI 1811798697
  NPD (past)
• Mercy Christian Health

  • Family Nurse Practitioner
  • Jackson, MI
  • NPI 1992228050
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1265533764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 GREENWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033077",
            "telephone_number": "517-962-0123",
            "fax_number": "517-201-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 GREENWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033077",
            "telephone_number": "517-962-0123",
            "fax_number": "517-201-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "SUSAN",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704219112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "83 20030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Beard
• Rachel Beatty
• Kelly Beck, LLPC, MA, CAADC
• Louis Mark Beck Jr., PTA
• Melissa Ann Beck
• Victoria Beck
• Connie Lynne Becker, CPHT
• Layna Beckermeyer
• Andrea M Beckman
• Beckord'S Inc.

• Pediatric Nurse Practitioner in Jackson, MI
• Providers in Jackson, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.