Individual provider Active NPI

Susan Elizaeth Gay, R.D.

  • Registered Dietitian
  • Westbrook, ME
National Provider Identifier
1093887507
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ME242271 Issued in ME
Practice address
201 Main St
5
Westbrook, ME 04092-4761
Phone
(207) 854-3663
Fax
(207) 854-3664
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ME242271 ME Primary

Addresses

Primary practice location

201 Main St
5
Westbrook, ME 04092-4761

Mailing address

201 Main St
5
Westbrook, ME 04092-4761
Phone (207) 854-3663

Other names 1

  • Miss Susan Elizabeth Weaver Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070410000230 ME Practitioner - Registered Dietitian Or Nutrition Professional 7113022716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nutrition Works,LLCGroup PAC ID 8123091667, 5 clinicians

Practice addresses (Care Compare)

805 Stevens Ave
Portland, ME 04103-2647
Phone (207) 772-6279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ME242271MEMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Works,LLC Dietitian, Registered CurrentSince Nov 21, 2015 Accepting new patients
DPD Nutrition Consultants, Inc Dietitian, Registered PastSince Nov 17, 2019 Accepting new patients
Deborah Pepper-Dougherty, Rd, LD Dietitian, Registered PastSince Dec 1, 2024 Accepting new patients

Locations

805 Stevens Ave
Portland, ME 04103
Phone (207) 772-6279

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093887507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MAIN ST",
            "address_2": "5",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924761",
            "telephone_number": "207-854-3663",
            "fax_number": "207-854-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MAIN ST",
            "address_2": "5",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924761",
            "telephone_number": "207-854-3663",
            "fax_number": "207-854-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAY",
        "first_name": "SUSAN",
        "middle_name": "ELIZAETH",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "ME242271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "WEAVER",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "R.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westbrook, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.