Individual provider Active NPI

Suzanne E. Wilton, A.P.N.

  • Adult Health Nurse Practitioner
  • Normal, IL
National Provider Identifier
1295953479
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209.001962 Issued in IL
Practice address
902 Franklin Ave
Normal, IL 61761-3510
Phone
(309) 888-5531
Fax
(309) 888-5530
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Nurse Practitioner 363LX0106X 209001962 IL
Adult Health Nurse Practitioner 363LA2200X 209.001962 IL Primary
Primary Care Nurse Practitioner 363LP2300X 209.001962 IL

Addresses

Primary practice location

902 Franklin Ave
Normal, IL 61761-3510

Mailing address

902 Franklin Ave
Normal, IL 61761-3510
Phone (309) 888-5531

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

State licenses

LicenseStateTypeSpecialty
209.001962ILMDPrimary Care Nurse Practitioner
209001962ILMDOccupational Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1295953479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613510",
            "telephone_number": "309-888-5531",
            "fax_number": "309-888-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613510",
            "telephone_number": "309-888-5531",
            "fax_number": "309-888-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTON",
        "first_name": "SUZANNE",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "IL",
            "license": "209001962",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.001962",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209.001962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; 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.