Individual provider Active NPI

Susan Perdue Schultz, CNP

  • Family Nurse Practitioner
  • Concord TWP, OH
National Provider Identifier
1508256975
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-16989 Issued in OH
Practice address
7590 Auburn Rd
Concord TWP, OH 44077-9176
Phone
(440) 375-8100
NPI assigned
Jan 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP-16989 OH Primary

Addresses

Primary practice location

7590 Auburn Rd
Concord TWP, OH 44077-9176

Mailing address

Dept 781789
PO Box 78000
Detroit, MI 48278-1789
Phone (440) 879-0081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150304002003 OH Practitioner - Nurse Practitioner 5799001020 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashtabula County Medical CenterGroup PAC ID 2668465600, 70 clinicians

Practice addresses (Care Compare)

2259 Lake Ave
Ashtabula, OH 44004-3437
Phone (440) 994-7654

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-6969

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-16989OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System Inc Current Accepting new patients
Ashtabula County Medical Center CurrentSince Feb 15, 2015 Accepting new patients
Lake Hospital System, Inc. CurrentSince Jun 6, 2015 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Lake Hospital System, Inc Past Accepting new patients

Locations

2422 Lake Ave
Ashtabula, OH 44004
Phone (440) 992-4422

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

2259 Lake Ave
Ashtabula, OH 44004
Phone (440) 994-7550

7590 Auburn Rd
Concord Township, OH 44077
Phone (440) 354-1899

234 N Chestnut St
Jefferson, OH 44047
Phone (440) 576-8933

Interoperability endpoints

  • Direct secure messaging: sperdueschultz284583@direct.ccf.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1508256975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 781789",
            "address_2": "PO BOX 78000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781789",
            "telephone_number": "440-879-0081",
            "fax_number": "440-879-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7590 AUBURN RD",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440779176",
            "telephone_number": "440-375-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDUE SCHULTZ",
        "first_name": "SUSAN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP-16989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord TWP, OH

Sources for this page

Verify at the official NPI Registry.