NPIMap

Individual provider Active NPI

Susan L Vild, MSN, RN, FNP C

  • Family Nurse Practitioner
  • Oregon, OH
National Provider Identifier
1801899083
Registry record updated Oct 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.05403 Issued in OH
Practice address
2815 Dustin Rd
Ste C
Oregon, OH 43616-3344
Phone
(419) 691-6781
Fax
(419) 691-0082
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.05403 OH Primary

Addresses

Primary practice location

2815 Dustin Rd
Ste C
Oregon, OH 43616-3344

Mailing address

2815 Dustin Rd
Ste C
Oregon, OH 43616-3344
Phone (419) 691-6781

Other identifiers 1

IdentifierTypeStateIssuer
2223061MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070322000238 OH Practitioner - Nurse Practitioner 3173627684 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
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians

Practice addresses (Care Compare)

2222 Cherry St
Toledo, OH 43608-2675

2815 Dustin Rd
Suite C
Oregon, OH 43616-3497
Phone (419) 691-6781

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
APRN.CNP.05403OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians - North, LLC CurrentSince Apr 25, 2011 Accepting new patients
Mercy Health Physicians-North LLC CurrentSince Apr 25, 2011 Accepting new patients
Promedica Central Physicians Past Accepting new patients
Promedica Central Physicians Nurse Practitioner Past Accepting new patients
Mercy Health System Northern Past Accepting new patients

Locations

2815 Dustin Rd
Ste C
Oregon, OH 43616
Phone (419) 691-5716

3851 Navarre Ave
Ste 200
Oregon, OH 43616
Phone (419) 691-6781

2200 Jefferson Ave
Fl 4
Toledo, OH 43604
Phone (419) 251-1400

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

Interoperability endpoints

  • Direct secure messaging: svild29970@direct.bsmhealth.org

Organizations & group practices 5

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728691200000",
    "number": "1801899083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 DUSTIN RD",
            "address_2": "STE C",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163344",
            "telephone_number": "419-691-6781",
            "fax_number": "419-691-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 DUSTIN RD",
            "address_2": "STE C",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163344",
            "telephone_number": "419-691-6781",
            "fax_number": "419-691-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILD",
        "first_name": "SUSAN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MSN, RN, FNP C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2024-10-12",
        "certification_date": "2024-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.05403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2223061",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

Verify at the official NPI Registry.