Active NPI
Suzanne P Stanek, N.P.
- Nurse Practitioner
- Columbus, OH
National Provider Identifier
1639156862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- COA.03054.NP
- Practice address
- 4030 West Henderson Road
Columbus, OH 43220 - Phone
- (614) 442-7500
- Fax
- (614) 442-4100
- NPI assigned
- Dec 29, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | COA.03054.NP | OH | Primary |
Addresses
Primary practice location
4030 West Henderson Road
Columbus, OH 43220
Mailing address
4030 West Henderson Road
Columbus, OH 43220
Phone (614) 442-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2601232 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| COA.03054.NP | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Central Ohio Primary Care Physicians, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Medical Laboratory
- Westerville, OH
- NPI 1639279045
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212451200000",
"number": "1639156862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4030 WEST HENDERSON ROAD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43220",
"telephone_number": "614-442-7500",
"fax_number": "614-442-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4030 WEST HENDERSON ROAD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43220",
"telephone_number": "614-442-7500",
"fax_number": "614-442-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANEK",
"first_name": "SUZANNE",
"middle_name": "P",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-29",
"last_updated": "2008-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "COA.03054.NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2601232",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.