Susan Leddy, C.N.P

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R023955 Issued in SD

Practice address

409 4TH St
Wilmot, SD 57279-2214

Phone

(605) 938-4351

Fax

(605) 938-4351

NPI assigned

Apr 17, 2006

Last updated

Mar 7, 2023By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avera McKennan

  dba Avera McKennan Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  NPD

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1447215207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14346 SD HIGHWAY 15",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572525415",
            "telephone_number": "605-432-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 4TH ST",
            "city": "WILMOT",
            "state": "SD",
            "postal_code": "572792214",
            "telephone_number": "605-938-4351",
            "fax_number": "605-938-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDDY",
        "first_name": "SUSAN",
        "credential": "C.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "R023955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE'S LICENSE",
            "identifier": "R023955",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avera McKennan (Avera Medical Group Wilmot)
• Coteau Des Prairies Hospital, Inc (Couteau Des Priaires Hospital & Clinic Wilmot)
• Coteau Des Prairies Hospital, Inc. (Coteau Des Prairies Wilmot Clinic)
• Amber Marie Herr, PHYSICAL THERAPIST A
• Wilmot Care Center
• Wilmot Care Center
• Wilmot Care Center
• Wilmot School District 54-7

• Nurse Practitioner in Wilmot, SD
• Providers in Wilmot, SD by specialty
• Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.