Abbigail Jean Sundell, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D-1382 Issued in ID

Practice address

775 Pole Line Rd W Ste 302
Twin Falls, ID 83301-5823

Phone

(208) 814-8780

NPI assigned

Aug 1, 2022

Last updated

Sep 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St Luke's Clinic LLC

  dba St Lukes Clinic - Magic Valley/Jerome

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229
  Medicare reassignment NPD

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1023745056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 POLE LINE RD W STE 302",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015823",
            "telephone_number": "208-814-8780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Pole Line Rd W",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833015810",
            "country_code": "US",
            "telephone_number": "702-338-1591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUNDELL",
        "first_name": "ABBIGAIL",
        "middle_name": "JEAN",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D-1382",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indira Suljic
• Summit Dental Care Group, PLLC
• Summit Recovery and Wellness
• Jason Michael Sumsion, MSPT
• Sunbridge Healthcare LLC (River Ridge Care and Rehabilitation Center)
• Sunrise Ridge PC
• Sunshine Therapy LLC (Sunshine Special Education Services)
• Charlene Surbaugh, R.N., F.A.
• Surgery Center (dba Sawtooth Surgery Center)
• Surgical Associates of Southern Id

• Registered Dietitian in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.