Individual provider Active NPI

Susan Joan Mesecar, NNP

  • Neonatal Nurse Practitioner
  • Wyoming, MI
National Provider Identifier
1417917410
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
4704127579 Issued in MI
Practice address
5900 Byron Center Ave SW
Wyoming, MI 49519
Phone
(616) 252-7200
NPI assigned
Mar 24, 2006
Last updated
Feb 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 4704127579 MI Primary

Addresses

Primary practice location

5900 Byron Center Ave SW
Wyoming, MI 49519

Mailing address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-3243

Other practice location 1

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-6902

Other practice location 2

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-6902

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

State licenses

LicenseStateTypeSpecialty
4704127579MIMDNeonatal Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: sbaileymesecar206749@epic00.corewelldirect.org

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1417917410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-252-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Jefferson Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034502",
            "country_code": "US",
            "telephone_number": "616-685-6902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Jefferson Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034502",
            "country_code": "US",
            "telephone_number": "616-685-6902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MESECAR",
        "first_name": "SUSAN",
        "middle_name": "JOAN",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MI",
            "license": "4704127579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.