Individual provider Active NPI

Rachel Marie Suidan, CNM

  • Advanced Practice Midwife
  • Ferndale, MI
National Provider Identifier
1720400492
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
4704276577 Issued in MI
Practice address
23338 Woodland Ave
Ferndale, MI 48220
Phone
(734) 926-4800
Fax
(734) 973-0595
NPI assigned
Jan 14, 2014
Last updated
Jun 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 4704276577 MI Primary

Addresses

Primary practice location

23338 Woodland Ave
Ferndale, MI 48220

Mailing address

950 Victors Way
Ste. 100
Ann Arbor, MI 48108
Phone (734) 926-4800

Other names 1

  • Mrs. Rachel Laporte Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713000244 MI Order and Referring Only - Certified Nurse Midwife (CNM) 4688986144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
4704276577MIMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Michigan Past Accepting new patients

Organizations & group practices 1

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": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1720400492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 VICTORS WAY",
            "address_2": "STE. 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-926-4800",
            "fax_number": "734-973-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23338 WOODLAND AVE",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "48220",
            "telephone_number": "734-926-4800",
            "fax_number": "734-973-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUIDAN",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-14",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704276577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "LAPORTE",
            "prefix": "MRS.",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ferndale, MI

Sources for this page

Verify at the official NPI Registry.