Individual provider Active NPI

Susan Wallace Barton, FNP-BC

  • Family Nurse Practitioner
  • Hammond, IN
National Provider Identifier
1700310950
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71013720B Issued in IN
Practice address
777 Casino Center Dr
Hammond, IN 46320-1003
Phone
(219) 473-6100
Fax
(219) 473-6147
NPI assigned
Apr 14, 2017
Last updated
Sep 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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 71013720B IN Primary

Addresses

Primary practice location

777 Casino Center Dr
Hammond, IN 46320-1003

Mailing address

777 Casino Center Dr
Hammond, IN 46320-1003
Phone (219) 473-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250212003519 IN Practitioner - Nurse Practitioner 7214206416 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71013720BINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premise Health of Indiana Medical PC CurrentSince Dec 9, 2024 Accepting new patients
Premise Health of Indiana Medical, P.C. Current Accepting new patients
Connecticut General Life Insurance Company PastSince Oct 1, 2023 Accepting new patients

Locations

777 Casino Center Dr
Hammond, IN 46320
Phone (219) 473-6100

5500 Maryland Way
Ste 120
Brentwood, TN 37027

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1700310950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CASINO CENTER DR",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201003",
            "telephone_number": "219-473-6100",
            "fax_number": "219-473-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CASINO CENTER DR",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201003",
            "telephone_number": "219-473-6100",
            "fax_number": "219-473-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTON",
        "first_name": "SUSAN",
        "middle_name": "WALLACE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71013720B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

Verify at the official NPI Registry.