Susan M Parks, RD,CSSD,LDN,CPT

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

N153 Issued in MN

Practice address

7300 Metro Blvd
Suite 140
Edina, MN 55439-2303

Phone

(651) 592-7830

Fax

(651) 405-3850

NPI assigned

Apr 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Institute for Exercise Medicine and Prevention

  • General Practice Physician
  • Saint Paul, MN
  • NPI 1063659647
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1043433576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2282 FIELD STONE DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201918",
            "telephone_number": "651-592-7830",
            "fax_number": "651-405-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 METRO BLVD",
            "address_2": "SUITE 140",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392303",
            "telephone_number": "651-592-7830",
            "fax_number": "651-405-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "RD,CSSD,LDN,CPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "N153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0063-0001350",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "400A3PA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Parker, CNP
• Jonathan Arthur Parker, D.D.S.
• Parkinsons Specialty Care
• Parklawnhealthservices LLC
• Kelsey Nicole Parks, MD
• Simmie J. Parlow, PH.D.
• Ashley Marie Parrington, DC
• Cari Parry, PT
• Sulekha Parshad, M.D.
• Vineela Paruchuri, BCBA

• Registered Dietitian in Edina, MN
• Providers in Edina, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.