Individual provider Active NPI

Susan Audrey Stark, MS, RD, LD

  • Registered Dietitian
  • Pittsburgh, PA
National Provider Identifier
1013102722
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN 000296 Issued in PA
Practice address
3459 5TH Ave
Pittsburgh, PA 15213-3236
Phone
(412) 647-2906
Fax
(412) 647-7839
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN 000296 PA Primary

Addresses

Primary practice location

3459 5TH Ave
Pittsburgh, PA 15213-3236

Mailing address

200 Lothrop St
Scaife Hall Suite S 1105.1
Pittsburgh, PA 15213-2536
Phone (412) 647-2906

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN 000296PAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1013102722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LOTHROP ST",
            "address_2": "SCAIFE HALL SUITE S 1105.1",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132536",
            "telephone_number": "412-647-2906",
            "fax_number": "412-647-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 5TH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133236",
            "telephone_number": "412-647-2906",
            "fax_number": "412-647-7839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "SUSAN",
        "middle_name": "AUDREY",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN 000296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.