Susan E Eadelman, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704214274 Issued in MI

Practice address

1091 S Beacon Blvd
Grand Haven, MI 49417-2607

Phone

(616) 604-0096

Fax

(616) 604-0095

NPI assigned

Sep 27, 2011

Last updated

Sep 27, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Synanon Inc

  • Urgent Care Clinic/Center
  • Grand Haven, MI
  • NPI 1588650261
  NPD

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1275816175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 S BEACON BLVD",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172607",
            "telephone_number": "616-604-0096",
            "fax_number": "616-604-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 S BEACON BLVD",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172607",
            "telephone_number": "616-604-0096",
            "fax_number": "616-604-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADELMAN",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704214274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hunter Bradley Dulaney, D.C.
• Courtney Lyn Dumouchelle, MS, CCC-SLP
• Frank Young Duncan III, MD
• Dunegrass Counseling
• Brittany Leigh Dykstra, SLP
• Kelly Eaton-Kelley
• Rileigh Elizabeth Grace Eding, PT, DPT
• Edson Medical Clinic, LLC (PCA Pain Care Center)
• Leah Edwards
• Patricia Janice Edwards, LMSW ACSW

• Nurse Practitioner in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.