Individual provider Active NPI

Susan Tallieu, N.P.

  • Acute Care Nurse Practitioner
  • Iowa City, IA
National Provider Identifier
1922424746
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
L163636 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-3441
Fax
(319) 467-5458
NPI assigned
Mar 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0992286 CO
Acute Care Nurse Practitioner 363LA2100X RN165820 AZ
Adult Health Nurse Practitioner 363LA2200X APN.0992286-NP CO
Acute Care Nurse Practitioner 363LA2100X L163636 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-3441

Other practice location 1

1635 Aurora Ct
Anschutz Outpatient Pavilion
Aurora, CO 80045-2541
Phone (855) 586-4824

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
I20211028002868 IA Practitioner - Nurse Practitioner 4880813930 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0992286COMDAcute Care Nurse Practitioner
L163636IAMDAcute Care Nurse Practitioner
APN.0992286-NPCOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Emergency Physicians LLP CurrentSince Nov 21, 2021 Accepting new patients
Iowa Emergency Physicians LLP Current Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1600 Morgan St
Keokuk, IA 52632
Phone (319) 524-7150

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-7050

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1922424746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-3441",
            "fax_number": "319-467-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-3441",
            "fax_number": "319-467-5458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1635 Aurora Ct",
            "address_2": "Anschutz Outpatient Pavilion",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452541",
            "country_code": "US",
            "telephone_number": "855-586-4824",
            "fax_number": "720-848-3445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALLIEU",
        "first_name": "SUSAN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-18",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "0992286",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "RN165820",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "APN.0992286-NP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IA",
            "license": "L163636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.