Individual provider Active NPI

Emma Joelle Surles, RD

  • Registered Dietitian
  • Raleigh, NC
National Provider Identifier
1104667971
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L007810 Issued in NC
Practice address
8548 Quarton Dr
Raleigh, NC 27616-5597
Phone
(919) 802-3453
NPI assigned
Jun 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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 L007810 NC Primary

Addresses

Primary practice location

8548 Quarton Dr
Raleigh, NC 27616-5597

Mailing address

8548 Quarton Dr
Raleigh, NC 27616-5597
Phone (919) 802-3453

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321000937 NY Practitioner - Registered Dietitian Or Nutrition Professional 7214459015 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L007810NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Lynn Nutrition Dietitian, Registered CurrentSince Jan 13, 2025 Accepting new patients
Lindatroia,LCSW, P.C. PastSince Jan 13, 2025 Accepting new patients

Locations

5100 W Genesee St
Camillus, NY 13031
Phone (315) 401-0590

Organizations & group practices 2

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": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1104667971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8548 QUARTON DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276165597",
            "telephone_number": "919-802-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8548 QUARTON DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276165597",
            "telephone_number": "919-802-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURLES",
        "first_name": "EMMA",
        "middle_name": "JOELLE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L007810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.