Active NPI
Susan Marshall, RD, CSPCC, CNSC
- Pediatric Critical Care Nutrition Registered Dietitian
- Aurora, CO
National Provider Identifier
1093535585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Nutrition Registered Dietitian
- License
- 966480
- Practice address
- 13123 E 16TH Ave # 270
Aurora, CO 80045-7106 - Phone
- (720) 777-4902
- NPI assigned
- Oct 10, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Nutrition Registered Dietitian | 133VN1401X | 966480 | Primary | |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 966480 |
Addresses
Primary practice location
13123 E 16TH Ave # 270
Aurora, CO 80045-7106
Mailing address
5628 S Quatar CT
Centennial, CO 80015-6005
Phone (530) 400-2557
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728518400000",
"number": "1093535585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5628 S QUATAR CT",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "800156005",
"telephone_number": "530-400-2557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13123 E 16TH AVE # 270",
"city": "AURORA",
"state": "CO",
"postal_code": "800457106",
"telephone_number": "720-777-4902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "SUSAN",
"credential": "RD, CSPCC, CNSC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-10",
"last_updated": "2024-10-10",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1401X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric Critical Care",
"state": null,
"license": "966480",
"primary": true
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": null,
"license": "966480",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.