Individual provider Active NPI

Susan Rhodes, L.D.

  • Registered Dietitian
  • Fort Worth, TX
National Provider Identifier
1164453403
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT84978 Issued in TX
Practice address
1250 8TH Ave Ste 135
Fort Worth, TX 76104-4156
Phone
(817) 923-8050
Fax
(817) 920-0562
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X LD 5675 OH
Registered Dietitian 133V00000X DT84978 TX Primary

Addresses

Primary practice location

1250 8TH Ave Ste 135
Fort Worth, TX 76104-4156

Mailing address

1420 Viceroy Dr
Dallas, TX 75235-2208
Phone (214) 358-2300

Other practice location 1

2615 Fort Amanda Rd
Lima, OH 45804-3730
Phone (419) 225-7300

Other identifiers 2

IdentifierTypeStateIssuer
RHMT73321OtherOHPIN NUMBER
DT84978OtherTNCOMMISSION ON DIETETIC REGISTRATION

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5675OHMDSchool Psychologist
LD 5675OHMDNutrition Education Nutritionist

Interoperability endpoints

  • Direct secure messaging: srhodes54676@direct.acumenmd.com

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1164453403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 VICEROY DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752352208",
            "telephone_number": "214-358-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 8TH AVE STE 135",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044156",
            "telephone_number": "817-923-8050",
            "fax_number": "817-920-0562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2615 Fort Amanda Rd",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458043730",
            "country_code": "US",
            "telephone_number": "419-225-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RHODES",
        "first_name": "SUSAN",
        "credential": "L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "OH",
            "license": "LD 5675",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT84978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN NUMBER",
            "identifier": "RHMT73321",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "DT84978",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.