Susan Eastabrooks, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP-09641 Issued in OH

Practice address

9485 Mentor Ave Ste 210
Primehealth
Mentor, OH 44060-8723

Phone

(440) 205-5833

NPI assigned

Nov 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Infinity Health Care, LLC

  • Nursing Care Agency
  • Westlake, OH
  • NPI 1902851587
  NPD (past)

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1396926317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5076",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440615076",
            "telephone_number": "440-209-8590",
            "fax_number": "440-209-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9485 MENTOR AVE STE 210",
            "address_2": "PRIMEHEALTH",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608723",
            "telephone_number": "440-205-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTABROOKS",
        "first_name": "SUSAN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP-09641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2797853",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PIN",
            "identifier": "P00626775",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan M Dykeman, MD
• E. V. Decastecker DDS Inc
• Eagen Management Inc.
• Earmark Audiology
• East Mentor Family Chiropractic & Rehabilitation, Inc.
• Mary Melissa Eaton, LISW
• Gary Mark Echt, LPCC LICDC
• Colin James Ecker, PHARMD
• Sergio Lynn Eddie, MSW, LSW
• Nathan Harlan Edminster, M.ED., LSC.

• Nurse Practitioner in Mentor, OH
• Providers in Mentor, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.