Active NPI
Susan J Adrian, NP
- Family Nurse Practitioner
- London, OH
National Provider Identifier
1396704763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP00603
- Practice address
- 55 Park Ave
Suite 230
London, OH 43140-1121 - Phone
- (740) 845-7600
- Fax
- (740) 845-7676
- NPI assigned
- Mar 22, 2006
- Last updated
- May 24, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP00603 | OH | Primary |
| Registered Nurse | 163W00000X | RN150849 | OH |
Addresses
Primary practice location
55 Park Ave
Suite 230
London, OH 43140-1121
Mailing address
PO Box 67250
Lincoln, NE 68506-7250
Phone (402) 328-8833
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 141867207028 | Other | OH | CARESOURCE |
| P00354251 | Other | OH | RRM |
| 000000286657 | Other | ANTHEM BCBS | |
| 2119764 | 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, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN150849 | OH | MD | Registered Nurse |
| NP00603 | OH | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274659200000",
"number": "1396704763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 67250",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685067250",
"telephone_number": "402-328-8833",
"fax_number": "402-328-2921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 PARK AVE",
"address_2": "SUITE 230",
"city": "LONDON",
"state": "OH",
"postal_code": "431401121",
"telephone_number": "740-845-7600",
"fax_number": "740-845-7676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADRIAN",
"first_name": "SUSAN",
"middle_name": "J",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-22",
"last_updated": "2010-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "NP00603",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN150849",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE",
"identifier": "141867207028",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RRM",
"identifier": "P00354251",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000286657",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2119764",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in London, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.