Individual provider Active NPI

Susan Lynn Rockhold

  • Nurse Practitioner
  • Independence, OH
National Provider Identifier
1811660335
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0029353 Issued in OH
Practice address
6480 Rockside Woods Blvd S Ste 330
Independence, OH 44131-2222
Phone
(855) 490-9434
Fax
(216) 238-9526
NPI assigned
Jul 29, 2021
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.0029353 OH Primary

Addresses

Primary practice location

6480 Rockside Woods Blvd S Ste 330
Independence, OH 44131-2222

Mailing address

500 Olde Worthington Rd Ste 100
Westerville, OH 43082-8913
Phone (440) 534-9556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240402002888 OH Order and Referring Only - Nurse Practitioner 2062804842

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0029353OHMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1811660335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 OLDE WORTHINGTON RD STE 100",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828913",
            "telephone_number": "440-534-9556",
            "fax_number": "216-238-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 ROCKSIDE WOODS BLVD S STE 330",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312222",
            "telephone_number": "855-490-9434",
            "fax_number": "216-238-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKHOLD",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0029353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.