Susan Adams, RN, APN
Individual provider Active NPI Nurse Practitioner · Macomb, IL
NPI 1922004332 · NPPES record last updated Feb 16, 2015
Key facts
- NPI
- 1922004332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 209004534 (IL)
- Practice address
- 1600 E Jackson St
Macomb, IL 61455-2530 - Phone
- (309) 833-4101
- NPI assigned
- Jun 22, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Graham Hospital Association
Practice addresses (Care Compare)
1630 E Jackson St
Macomb, IL 61455-2530
Phone (309) 647-0201
Hospital & facility affiliations
- MC Donough District Hospital
- Graham Hospital Association
- Graham Hospital Association
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060116000187 | IL | Practitioner - Nurse Practitioner | 0143244392 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209004534 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current | 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 | |
| Graham Hospital Association | Current |
Accepting new patients | |
| McDonough County Hospital District | Current | 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 | |
| Graham Hospital Association | Past | 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
525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611
1630 E Jackson St
Macomb, IL 61455
Phone (309) 647-5240
505 E Grant St
Ste 202
Macomb, IL 61455
Phone (309) 833-1729
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209004534 | IL | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 148952 | Other | IL | MEDICARE PART A |
Other providers in Macomb, IL
- Finny Abraham
- Advanced Physical Therapy Services, LTD.
- Age Rehab & Medical Fitness
- Air Evac EMS, Inc.
- Kenneth Dale Albert Jr.
- Mariia Aleshina
All providers in Macomb, IL · Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.