Individual provider Active NPI

Susan D McEwen, FNP

  • Family Nurse Practitioner
  • Kalispell, MT
National Provider Identifier
1598086522
Registry record updated Feb 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20633 Issued in MT
Practice address
715 S Main St
Kalispell, MT 59901-5358
Phone
(406) 606-6160
Fax
(406) 890-6645
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2025

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 20633 MT Primary

Addresses

Primary practice location

715 S Main St
Kalispell, MT 59901-5358

Mailing address

411 Orchard Ridge Rd
Kalispell, MT 59901-7565
Phone (406) 606-6160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20101113000258 MT Practitioner - Nurse Practitioner 0446445654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

715 S Main St
Kalispell, MT 59901-5358
Phone (406) 606-6160

Hospital & facility affiliations

  • Logan Health Medical Center Hospital, Kalispell, MT, CCN 270051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20633MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Body Balance Health and Wellness Clinic LLC Family CurrentSince Apr 14, 2024 Accepting new patients

Locations

715 S Main St
Kalispell, MT 59901
Phone (406) 606-6160

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGHGDD/Endpoint/EGHGDD

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.

Hospital & facility affiliations 7

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": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738972800000",
    "number": "1598086522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 ORCHARD RIDGE RD",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599017565",
            "telephone_number": "406-606-6160",
            "fax_number": "406-890-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S MAIN ST",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599015358",
            "telephone_number": "406-606-6160",
            "fax_number": "406-890-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEWEN",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2025-02-08",
        "certification_date": "2025-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "20633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.