Susan Carol Fabrick, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301064116 Issued in MI

Practice address

2700 Baker St FL 3
Muskegon, MI 49444-2157

Phone

(231) 737-1335

Fax

(231) 737-0534

NPI assigned

Aug 5, 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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Hackley Community Care Center Inc

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1629066238

  Family Medicine

  Medicare reassignment NPD
• Hackley Community Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1427787621
  NPD
• HPCN

  • Family Medicine Physician
  • Muskegon, MI
  • NPI 1184793408
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1891704599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST FL 3",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157",
            "telephone_number": "231-737-1335",
            "fax_number": "231-737-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST FL 3",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157",
            "telephone_number": "231-737-1335",
            "fax_number": "231-737-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRICK",
        "first_name": "SUSAN",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301064116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "4748904",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0806110231",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fabricks@hccc-health.org",
            "affiliation": "N",
            "endpointDescription": "Hackley Community Care Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "2700 Baker St Fl 3",
            "city": "Muskegon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494442157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shelly Ann Evans, RN
• Every Woman'S Place
• Eyemart Express LLC
• Jefferson Christopher Eyke, M.D.
• Fa Ho Lo Family Inc
• Emily J Faccin, OD
• Elizabeth Fadaka
• Peyton Paul Faganel, DO
• Kevin W Fairfield, DDS
• Jon Joseph Fakler, RN

• Family Medicine Physician in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.