Active NPI
Katie Surman, RD
- Registered Dietitian
- Carterville, IL
National Provider Identifier
1033038005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.006150
- Practice address
- 1006 S Division St
Carterville, IL 62918-1539 - Phone
- (618) 519-9200
- Fax
- (618) 985-3774
- NPI assigned
- Jul 14, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.006150 | IL | Primary |
Addresses
Primary practice location
1006 S Division St
Carterville, IL 62918-1539
Mailing address
109 California St
PO Box 577
Carterville, IL 62918
Phone (618) 519-9200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
109 California St
Carterville, IL 62918-1923
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1783987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1033038005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 CALIFORNIA ST",
"address_2": "PO BOX 577",
"city": "CARTERVILLE",
"state": "IL",
"postal_code": "62918",
"telephone_number": "618-519-9200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1006 S DIVISION ST",
"city": "CARTERVILLE",
"state": "IL",
"postal_code": "629181539",
"telephone_number": "618-519-9200",
"fax_number": "618-985-3774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURMAN",
"first_name": "KATIE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-14",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.006150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carterville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.