Active NPI
Susan K Ivester, RD,LD
- Registered Dietitian
- Round Rock, TX
National Provider Identifier
1053549055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT01314
- Practice address
- 1901 E Palm Valley Blvd
Round Rock, TX 78664-9421 - Phone
- (512) 694-6923
- NPI assigned
- Jun 29, 2009
- 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 | DT01314 | TX | Primary |
Addresses
Primary practice location
1901 E Palm Valley Blvd
Round Rock, TX 78664-9421
Mailing address
4131 Spicewood SPGS Ste L4
Austin, TX 78759-8652
Phone (512) 694-6923
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT01314 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sparkman Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Wilfong Nutrition Limited Liability Company | Dietitian, Registered | Past | Accepting new patients |
| Sparkman Nutrition, LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Registered Dietitian
- West Lake Hills, TX
- NPI 1518464650
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366243200000",
"number": "1053549055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4131 SPICEWOOD SPGS STE L4",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598652",
"telephone_number": "512-694-6923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 E PALM VALLEY BLVD",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786649421",
"telephone_number": "512-694-6923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVESTER",
"first_name": "SUSAN",
"middle_name": "K",
"credential": "RD,LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-29",
"last_updated": "2013-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT01314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.