Individual provider Active NPI

Erin Satullo, RN

  • Family Nurse Practitioner
  • Lakewood, OH
National Provider Identifier
1346682309
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.19116-NP Issued in OH
Practice address
11706 Clifton Blvd
Lakewood, OH 44107-2018
Phone
(216) 228-9296
NPI assigned
Jul 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 318147 OH
Family Nurse Practitioner 363LF0000X COA.19116-NP OH Primary

Addresses

Primary practice location

11706 Clifton Blvd
Lakewood, OH 44107-2018

Mailing address

13425 Clifton Blvd
Lakewood, OH 44107-1430

Other identifiers 1

IdentifierTypeStateIssuer
VADOOOtherUPIN

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 318147OHMDRegistered Nurse
COA.19116-NPOHMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1346682309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13425 CLIFTON BLVD",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441071430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11706 CLIFTON BLVD",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072018",
            "telephone_number": "216-228-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATULLO",
        "first_name": "ERIN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-19",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN 318147",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.19116-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "VADOO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.