Susan Elaine Nelson, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209000774 Issued in IL

Practice address

301 N 8TH St # 4B
Springfield, IL 62701-1041

Phone

(217) 545-8000

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Siu Physicians & Surgeons, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1750482121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 8TH ST # 4B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011041",
            "telephone_number": "217-545-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "62702",
            "country_code": "US",
            "telephone_number": "217-528-7541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SUSAN",
        "middle_name": "ELAINE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209000774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susannelson@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "301 N 8th St # 4B",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627011041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Brennan Nelson
• Jordan M. Nelson, DPT
• Rebecca Nelson
• Rustie Marie Nelson
• Seth Nelson, PHARM D
• Tara Marie Nelson, OTR/L
• Swetha Nemargommula, M.D
• Vera Nemsadze, M.D.
• Michael E Nenaber, M.D.
• Hitekshya Nepal, MD

• Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.