Active NPI
Susan Rhodes, L.D.
- Registered Dietitian
- Fort Worth, TX
National Provider Identifier
1164453403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT84978
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RHMT73321 | Other | OH | PIN NUMBER |
| DT84978 | Other | TN | COMMISSION 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
| License | State | Type | Specialty |
|---|---|---|---|
| 5675 | OH | MD | School Psychologist |
| LD 5675 | OH | MD | Nutrition Education Nutritionist |
Interoperability endpoints
- 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.