Active NPI
Susan Tissier, R.D.
- Registered Dietitian
- Reno, NV
National Provider Identifier
1144276718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 611314
- Practice address
- 1715 Kuenzli St
Reno, NV 89502-1117 - Phone
- (775) 329-5162
- Fax
- (775) 334-4365
- NPI assigned
- May 25, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 611314 | NV | Primary |
Addresses
Primary practice location
1715 Kuenzli St
Reno, NV 89502-1117
Mailing address
1715 Kuenzli St
Reno, NV 89502-1117
Phone (775) 329-5162
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004716904 | Medicaid | NV |
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 |
|---|---|---|---|
| 611314 | NV | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251936000000",
"number": "1144276718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 KUENZLI ST",
"city": "RENO",
"state": "NV",
"postal_code": "895021117",
"telephone_number": "775-329-5162",
"fax_number": "775-334-4365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715 KUENZLI ST",
"city": "RENO",
"state": "NV",
"postal_code": "895021117",
"telephone_number": "775-329-5162",
"fax_number": "775-334-4365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TISSIER",
"first_name": "SUSAN",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2009-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NV",
"license": "611314",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004716904",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.