Susan A Jordan, REGISTERED DIETITION

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT06018 Issued in TX

Practice address

1010 South
7650 East
Crow Agency, MT 59022-0022

Phone

(406) 638-3553

Fax

(406) 638-3553

NPI assigned

Sep 23, 2006

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

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1073613709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "HARDIN",
            "state": "MT",
            "postal_code": "590340108",
            "telephone_number": "406-638-3553",
            "fax_number": "406-638-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SOUTH",
            "address_2": "7650 EAST",
            "city": "CROW AGENCY",
            "state": "MT",
            "postal_code": "590220022",
            "telephone_number": "406-638-3553",
            "fax_number": "406-638-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SUSAN",
        "middle_name": "A",
        "credential": "REGISTERED DIETITION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT06018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2210068",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD",
            "identifier": "DT06018",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Marie Horseman, RN
• Indian Health Service
• Wesley Johnson
• Angela Johnston Schindler
• Candace Dixon Jones, CPP
• Jill C Kehler, RN
• Heather May Klug, PHARMD
• Maria Kofas
• Kelsey Kroon, PHARMD
• Melissa Kuntz

• Registered Dietitian in Crow Agency, MT
• Providers in Crow Agency, MT by specialty
• Registered Dietitian in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.