Individual provider Active NPI

Susan J Adrian, NP

  • Family Nurse Practitioner
  • London, OH
National Provider Identifier
1396704763
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP00603 Issued in OH
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, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
141867207028OtherOHCARESOURCE
P00354251OtherOHRRM
000000286657OtherANTHEM BCBS
2119764MedicaidOH

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

LicenseStateTypeSpecialty
RN150849OHMDRegistered Nurse
NP00603OHMDFamily 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.

Verify at the official NPI Registry.