Susan Marie Eley, PH.D., FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209003830 Issued in IL

Practice address

2401 W Main St
Marion, IL 62959-1188

Phone

(618) 997-5311

NPI assigned

Jan 13, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

State licenses

Practice roles

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.

• Crossroads Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Effingham, IL
  • NPI 1023033982

  Nurse Practitioner

  NPD (past)
• Sarah Bush Lincoln Health Center

  • Rural Health Clinic/Center
  • Greenville, IL
  • NPI 1811858970
  NPD (past)

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1285871202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16137 LYNN ACRES",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624017496",
            "telephone_number": "217-821-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEY",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PH.D., FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-13",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209003830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Killian Edmondson
• Jason Christopher Edwards, LPC
• David Eichhorn, RRT
• Flor Eldridge, LCSW
• Stephanie Jean Eldridge
• Krista Elliott
• Clara Nanette Ellis, OTR/L
• Erin Marie Ellis, M.S. CFY-SLP
• Maria F Elmquist, LSW
• Medhat Elsherbini, MD

• All providers in Marion, IL
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.