NPIMap

Individual provider Active NPI

Susan M. Eastman, ARNP

  • Adult Health Nurse Practitioner
  • Reardan, WA
National Provider Identifier
1629011788
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP30000282 Issued in WA
Practice address
East 115 Broadway
Reardan, WA 99029-0629
Phone
(509) 796-2737
Fax
(509) 796-2738
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00049615 WA
Adult Health Nurse Practitioner 363LA2200X AP30000282 WA Primary

Addresses

Primary practice location

East 115 Broadway
Reardan, WA 99029-0629

Mailing address

100 3Rd St
Suite 1
Davenport, WA 99122-9730
Phone (509) 725-7501

Other identifiers 6

IdentifierTypeStateIssuer
CJ6525OtherWAMEDICARE RAILROAD
9600123MedicaidWA
142721OtherWADEPT. OF L & I
7101132MedicaidWA
500023044OtherWAMEDICARE RAILROAD
7117450MedicaidWA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln County Hospital District 3 Past Accepting new patients
Lincoln County Hospital District #3 Past Accepting new patients
Lincoln County Hospital District 3 Past Accepting new patients
Lincoln County Hospital District 3 Past Accepting new patients
Lincoln County Hospital District #3 Past Accepting new patients
Lincoln County Hospital District 3 Past Accepting new patients
Lincoln County Hospital District #3 / North Basin Medical Clinics Past Accepting new patients

Organizations & group practices 7

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1629011788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 3RD ST",
            "address_2": "SUITE 1",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229730",
            "telephone_number": "509-725-7501",
            "fax_number": "509-725-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST 115 BROADWAY",
            "city": "REARDAN",
            "state": "WA",
            "postal_code": "990290629",
            "telephone_number": "509-796-2737",
            "fax_number": "509-796-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00049615",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP30000282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CJ6525",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9600123",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF L & I",
            "identifier": "142721",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101132",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "500023044",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7117450",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reardan, WA

Sources for this page

  • 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.