Active NPI
Susan Diane Picciano, CNP
- Pediatric Nurse Practitioner
- Circleville, OH
National Provider Identifier
1306078530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- COA10852-NP
- Practice address
- 600 N Pickaway St
Suite 300
Circleville, OH 43113-1447 - Phone
- (740) 420-8632
- Fax
- (740) 420-8633
- NPI assigned
- Aug 21, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | COA10852-NP | OH | Primary |
Addresses
Primary practice location
600 N Pickaway St
Suite 300
Circleville, OH 43113-1447
Mailing address
600 N Pickaway St
Suite 300
Circleville, OH 43113-1447
Phone (740) 420-8632
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2985962 | Medicaid | OH |
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
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA10852-NP | OH | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359590400000",
"number": "1306078530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N PICKAWAY ST",
"address_2": "SUITE 300",
"city": "CIRCLEVILLE",
"state": "OH",
"postal_code": "431131447",
"telephone_number": "740-420-8632",
"fax_number": "740-420-8633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N PICKAWAY ST",
"address_2": "SUITE 300",
"city": "CIRCLEVILLE",
"state": "OH",
"postal_code": "431131447",
"telephone_number": "740-420-8632",
"fax_number": "740-420-8633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICCIANO",
"first_name": "SUSAN",
"middle_name": "DIANE",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-21",
"last_updated": "2013-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "OH",
"license": "COA10852-NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2985962",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Circleville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.