JACQUELINE ANN SUPPAN MSN, CNS
NPI 1124084777
Nurse Practitioner - Primary Care in Wooster, OH

Q: What is Jacqueline Suppan's NPI number?

The NPI number for Jacqueline Suppan is 1124084777. It was assigned to this individual provider in the NPPES registry on April 24, 2006.

Q: What is Jacqueline Suppan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Jacqueline Suppan was last updated on December 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 24, 2006PECOS EnrolledAccepts Medicare Assignment

1740 CLEVELAND RD, WOOSTER, OH 44691(330) 287-4500(330) 287-4929 Get Directions Write a Review

NPPES record last updated: December 18, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jacqueline Ann Suppan Msn, Cns NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE ANN SUPPAN MSN, CNS (NPI 1124084777) is an individual primary care provider in Wooster, Ohio, licensed in Ohio (APRN.CNP.0036720) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Wooster Community Hospital, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1124084777

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameJACQUELINE ANN SUPPANCredential: MSN, CNS

Location Address1740 CLEVELAND RDWooster, OH 44691-2204

Mailing Address2825 E Paradise Street ExtOrrville, OH 44667-9621 · (330) 234-0935

Phone(330) 287-4500

Fax(330) 287-4929

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateApril 24, 2006

Last NPPES UpdateDecember 18, 2025

NPPES CertifiedDecember 18, 2025

✔ NPI 1124084777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in OH · APRN.CNP.0036720

Also ListedClinical Nurse Specialist · Adult HealthTaxonomy 364SA2200X · License CTP-06570 (OH)

1740 CLEVELAND RD, Wooster, OH 44691

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacqueline Ann Suppan Msn, Cns is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547317562

PECOS Enrollment IDI20090409000043

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

187 services109 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

88 services78 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

71 services40 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

23 services23 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

23 services23 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wooster Community Hospital

Acute Care Hospitals · Wooster, OH

5/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number360036

Location1761 Beall AvenueWooster, OH 44691 · Wayne County

Emergency services Birthing friendly

Cleveland Clinic

Acute Care Hospitals · Cleveland, OH

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360180

Location9500 Euclid AvenueCleveland, OH 44195 · Cuyahoga County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44691 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers17 claims17 services$187.08 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. THERESA KIMBERLEY MALMON-BERG M.S.N., C.N.P.

Nurse Practitioner (Family)