Individual provider Active NPI

Suzanne Roache Schiltz, RN

  • Registered Nurse First Assistant
  • Vancouver, WA
National Provider Identifier
1700939733
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
090003001RN Issued in OR
Practice address
11611 NW 10TH CT
Vancouver, WA 98685
Phone
(360) 608-3246
NPI assigned
Jan 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 090003001RN OR Primary

Addresses

Primary practice location

11611 NW 10TH CT
Vancouver, WA 98685

Mailing address

11611 NW 10TH CT
Vancouver, WA 98685
Phone (360) 608-3246

Other identifiers 2

IdentifierTypeStateIssuer
000317MedicaidOR
015402000OtherORBLUE CROSS

Other names 1

  • Suzanne Roache Martin Former name

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
090003001RNORMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1700939733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11611 NW 10TH CT",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98685",
            "telephone_number": "360-608-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11611 NW 10TH CT",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98685",
            "telephone_number": "360-608-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILTZ",
        "first_name": "SUZANNE",
        "middle_name": "ROACHE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-21",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "OR",
            "license": "090003001RN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000317",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "015402000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "MARTIN",
            "middle_name": "ROACHE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.