Individual provider Active NPI

Suzanne Willard Niemela, MD

  • Internal Medicine Physician
  • Chester, MD
National Provider Identifier
1346217361
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0047311 Issued in MD
Practice address
1630 Main St
Suite 101
Chester, MD 21619-2791
Phone
(410) 604-6591
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0047311 MD Primary

Addresses

Primary practice location

1630 Main St
Suite 101
Chester, MD 21619-2791

Mailing address

PO Box 12622
Belfast, ME 04915-4017
Phone (443) 481-6577

Other identifiers 3

IdentifierTypeStateIssuer
53450302OtherMDCAREFIRST
371201000MedicaidMD
J1740002OtherDCCAREFIRST

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0047311MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1346217361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12622",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154017",
            "telephone_number": "443-481-6577",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MAIN ST",
            "address_2": "SUITE 101",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192791",
            "telephone_number": "410-604-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMELA",
        "first_name": "SUZANNE",
        "middle_name": "WILLARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0047311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "53450302",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371201000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "J1740002",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; 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.