NPIMap

Individual provider Active NPI

Susan Adams, RN, APN

  • Nurse Practitioner
  • Macomb, IL
National Provider Identifier
1922004332
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209004534 Issued in IL
Practice address
1600 E Jackson St
Macomb, IL 61455-2530
Phone
(309) 833-4101
NPI assigned
Jun 22, 2005
Last updated
Feb 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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 209004534 IL Primary

Addresses

Primary practice location

1600 E Jackson St
Macomb, IL 61455-2530

Mailing address

PO Box 1179
Macomb, IL 61455-5579
Phone (309) 833-4101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20060116000187 IL Practitioner - Nurse Practitioner 0143244392 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians

Practice addresses (Care Compare)

1630 E Jackson St
Macomb, IL 61455-2530
Phone (309) 647-0201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209004534ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District Current Accepting new patients
Graham Hospital Association CurrentSince Dec 8, 2024 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
Graham Hospital Association CurrentSince Dec 8, 2024 Accepting new patients
Graham Hospital Association Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District CurrentSince May 25, 2020 Accepting new patients
Bushnell Family Practice, SC Past Accepting new patients

Locations

1150 N Cole St
Bushnell, IL 61422
Phone (309) 772-2255

175 S Main St
Canton, IL 61520
Phone (309) 647-3937

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

1630 E Jackson St
Macomb, IL 61455
Phone (309) 647-5240

505 E Grant St
Ste 202
Macomb, IL 61455
Phone (309) 833-1729

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1922004332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1179",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614555579",
            "telephone_number": "309-833-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E JACKSON ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552530",
            "telephone_number": "309-833-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "SUSAN",
        "credential": "RN, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209004534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

Verify at the official NPI Registry.