Individual provider Active NPI

Susan Jean Eklund, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Ypsilanti, MI
National Provider Identifier
1457596421
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704164957 Issued in MI
Practice address
5333 McAuley Dr RM 4003
Ypsilanti, MI 48197-1099
Phone
(734) 712-3470
Fax
(734) 712-2935
NPI assigned
Dec 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704164957 MI Primary

Addresses

Primary practice location

5333 McAuley Dr RM 4003
Ypsilanti, MI 48197-1099

Mailing address

5333 McAuley Dr RM 4003
Ypsilanti, MI 48197-1099
Phone (734) 712-3470

Other names 1

  • Ms. Susan Jean Robinson Former name

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704164957MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Multispecialty Physicians, P.C. Adult Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1457596421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR RM 4003",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971099",
            "telephone_number": "734-712-3470",
            "fax_number": "734-712-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR RM 4003",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971099",
            "telephone_number": "734-712-3470",
            "fax_number": "734-712-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKLUND",
        "first_name": "SUSAN",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704164957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "ROBINSON",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "NURSE PRACTITIONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; 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.