Susannah Lin Edwards, MS RDN LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DX4187 Issued in MD

Practice address

10215 Fernwood Rd
Suite 630
Bethesda, MD 20817-1106

Phone

(240) 449-3094

Fax

(240) 489-4415

NPI assigned

Apr 4, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC

  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • MC Lean, VA
  • NPI 1376815472
  NPD

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1154854545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 BLACK OAK LN",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209101423",
            "telephone_number": "240-449-3094",
            "fax_number": "240-489-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 FERNWOOD RD",
            "address_2": "SUITE 630",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171106",
            "telephone_number": "240-449-3094",
            "fax_number": "240-489-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SUSANNAH",
        "middle_name": "LIN",
        "name_prefix": "Ms.",
        "credential": "MS RDN LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX4187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10215 Fernwood Rd",
            "address_2": "Suite 630",
            "city": "Bethesda",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208171106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeremy Vaughan Edwards, D.O.
• Joanna Tyler Edwards
• Kimberly Yvonne Edwards, M.ED.,CCC-SLP
• Michelle Marie Edwards, MD, MPH
• Polo Lynn Edwards, DPT
• Tayana Capri Edwards
• Matthew Allen Edwardson, MD
• Abigail Eva Effron
• Brian Efianayi
• Allison Egan, DPT

• Registered Dietitian in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Registered Dietitian in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.