Active NPI
Suzanne Elizabeth Magnotta, R.D.
- Registered Dietitian
- Greenwich, CT
National Provider Identifier
1114156239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 852526
- Practice address
- 37 Halock Dr
Greenwich, CT 06831-5010 - Phone
- (203) 863-3667
- NPI assigned
- Jul 10, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 852526 | Primary | |
| Registered Dietitian | 133V00000X | 005693 | NY |
Addresses
Primary practice location
37 Halock Dr
Greenwich, CT 06831-5010
Mailing address
37 Halock Dr
Greenwich, CT 06831-5010
Phone (203) 863-3667
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 |
|---|---|---|---|
| 000585 | CT | MD | Mental Health Counselor |
| 005693 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247184000000",
"number": "1114156239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 HALOCK DR",
"city": "GREENWICH",
"state": "CT",
"postal_code": "068315010",
"telephone_number": "203-863-3667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 HALOCK DR",
"city": "GREENWICH",
"state": "CT",
"postal_code": "068315010",
"telephone_number": "203-863-3667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGNOTTA",
"first_name": "SUZANNE",
"middle_name": "ELIZABETH",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-10",
"last_updated": "2009-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "852526",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "005693",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.