Susan R Wilson, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704149259 Issued in MI

Practice address

463 E Circle Dr
East Lansing, MI 48824-7500

Phone

(517) 884-6546

Fax

(517) 432-9460

NPI assigned

Mar 9, 2010

Last updated

Jun 8, 2016By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1801119532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD",
            "address_2": "A201",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 E CIRCLE DR",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247500",
            "telephone_number": "517-884-6546",
            "fax_number": "517-432-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704149259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801119532",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie Fons Wilson, PHD
• Jenee Wilson, MS, LLPC
• Mary Wilson, MT-BC
• Megan Wilson
• Melissa Marie Wilson, LMSW, MPH
• Zachary Michael Wilson, DO
• Amy Wimberly-Kacel, NP
• Nicole Winckelmann Palma
• Windler Beattie Consulting
• Andrea Winemiller

• Family Nurse Practitioner in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.