Individual provider Active NPI

Susan M Truitt, OD

  • Optometrist
  • Marysville, OH
National Provider Identifier
1952343535
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3761 Issued in OH
Practice address
1001 W Fifth St
Marysville, OH 43040
Phone
(937) 644-8637
Fax
(937) 644-8653
NPI assigned
Jun 11, 2006
Last updated
Apr 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3761 OH Primary

Addresses

Primary practice location

1001 W Fifth St
Marysville, OH 43040

Mailing address

1001 W 5TH St
Marysville, OH 43040-8666
Phone (937) 644-8637

Other identifiers 1

IdentifierTypeStateIssuer
2774350MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Source Marysville Optometrist CurrentSince Jul 1, 1997 Accepting new patients

Locations

1001 W 5th St
Marysville, OH 43040
Phone (937) 644-8637

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1952343535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W 5TH ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430408666",
            "telephone_number": "937-644-8637",
            "fax_number": "937-644-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W FIFTH ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "43040",
            "telephone_number": "937-644-8637",
            "fax_number": "937-644-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUITT",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2774350",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.