Individual provider Active NPI

Susan Leann Wilson, ARNP A-GNP-C

  • Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1871021543
Registry record updated May 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
H085003 Issued in IA
Practice address
1801 Hickman Rd
Des Moines, IA 50314-1505
Phone
(515) 282-5695
Fax
(515) 282-7823
NPI assigned
May 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2017

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 H085003 IA Primary

Addresses

Primary practice location

1801 Hickman Rd
Des Moines, IA 50314-1505

Mailing address

1513 S 3Rd St
Indianola, IA 50125-9705
Phone (515) 314-7498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20170808000190 IA Practitioner - Nurse Practitioner 7517238652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Broadlawns Medical CenterGroup PAC ID 3678466166, 302 clinicians

Practice addresses (Care Compare)

1801 Hickman Rd
Des Moines, IA 50314-1548
Phone (515) 282-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.61 of 100Reported as group
Quality
75.16
Promoting interoperability
100
Improvement activities
40
Cost
76.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince Jul 1, 2017 Accepting new patients
Broadlawns Medical Center CurrentSince Jul 1, 2017 Accepting new patients

Locations

1801 Hickman Rd
Bldg First
Des Moines, IA 50314

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

Interoperability endpoints

  • Direct secure messaging: wilson.susan@cynchealthdsm.org

Organizations & group practices 2

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 1

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": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1871021543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 S 3RD ST",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501259705",
            "telephone_number": "515-314-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141505",
            "telephone_number": "515-282-5695",
            "fax_number": "515-282-7823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SUSAN",
        "middle_name": "LEANN",
        "credential": "ARNP  A-GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2017-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "H085003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.