NPIMap

Individual provider Active NPI

Susan Renee Tuttle, APN

  • Nurse Practitioner
  • Red Bud, IL
National Provider Identifier
1740286988
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.003723 Issued in IL
Practice address
325 Spring St
Red Bud, IL 62278-1105
Phone
(618) 282-7373
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209003723 IL
Nurse Practitioner 363L00000X 209.003723 IL Primary

Addresses

Primary practice location

325 Spring St
Red Bud, IL 62278-1105

Mailing address

325 Spring St
Red Bud, IL 62278-1105
Phone (618) 282-7373

Other names 1

  • Susie Tuttle Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100421000692 IL Practitioner - Nurse Practitioner 0345377438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red Bud Illinois Hospital Company LLCGroup PAC ID 2466416821, 15 clinicians
Deaconess Illinois Red Bud Regional Hospital IncGroup PAC ID 9537531579, 15 clinicians

Practice addresses (Care Compare)

325 Spring St
Red Bud, IL 62278-1105

Hospital & facility affiliations

  • Red Bud Regional Home Care Home health agency, Red Bud, IL, CCN 147486
  • At Home Health Care Home health agency, Sparta, IL, CCN 147694
  • Hospice of Southern Illinois, Inc Hospice, Belleville, IL, CCN 141504
  • Red Bud Regional Hospital Hospital, Red Bud, IL, CCN 141348
  • Memorial Hospital Hospital, Chester, IL, CCN 141338
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.003723ILMDNurse Practitioner
209003723ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Red Bud Regional Hospital Inc Nurse Practitioner CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Red Bud Regional Hospital Inc CurrentSince Jan 14, 2023 Accepting new patients
DRS Pichet & Meechai Past Accepting new patients
Red Bud Illinois Hospital Company LLC Past Accepting new patients
Specialized Wound Management LLC Adult Health Past Accepting new patients
Red Bud Clinic Corp Past Accepting new patients

Locations

325 Spring St
Redbud, IL 62278
Phone (618) 282-5165

325 Spring St
#2
Redbud, IL 62278
Phone (314) 835-0001

Interoperability endpoints

  • Direct secure messaging: susan.tuttle.1@27782.direct.athenahealth.com
  • Direct secure messaging: susan_r_tuttle_-_nurse_practitioner_clinic@yourcarecommunity.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1740286988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 SPRING ST",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622781105",
            "telephone_number": "618-282-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SPRING ST",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622781105",
            "telephone_number": "618-282-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "SUSAN",
        "middle_name": "RENEE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209003723",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.003723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSIE",
            "last_name": "TUTTLE",
            "credential": "N.P.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Red Bud, IL

Sources for this page

Verify at the official NPI Registry.