Individual provider Active NPI

Marshe Suderman, FNP, CNS

  • Perinatal Clinical Nurse Specialist
  • Kalamazoo, MI
National Provider Identifier
1710591680
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Perinatal Clinical Nurse SpecialistTaxonomy code 364SP1700X
License
4704141675 Issued in MI
Practice address
601 John St
Kalamazoo, MI 49007-5341
Phone
(269) 341-7485
NPI assigned
Sep 8, 2020
Last updated
Sep 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704141675 MI
Perinatal Clinical Nurse Specialist 364SP1700X 4704141675 MI Primary

Addresses

Primary practice location

601 John St
Kalamazoo, MI 49007-5341

Mailing address

52156 Kern Dr
Three Rivers, MI 49093-8921
Phone (269) 330-3716

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
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
4704141675MIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1710591680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52156 KERN DR",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938921",
            "telephone_number": "269-330-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDERMAN",
        "first_name": "MARSHE",
        "credential": "FNP, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704141675",
            "primary": false
        },
        {
            "code": "364SP1700X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Perinatal",
            "state": "MI",
            "license": "4704141675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.