Individual provider Active NPI

Flavia Souza, R.D.N.

  • Registered Dietitian
  • Duluth, GA
National Provider Identifier
1184158016
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD004422 Issued in GA
Practice address
3215 McClure Bridge Rd
Duluth, GA 30096-3223
Phone
(678) 312-6042
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD004422 GA Primary

Addresses

Primary practice location

3215 McClure Bridge Rd
Duluth, GA 30096-3223

Mailing address

2576 Kenwood Dr
Duluth, GA 30096-3636
Phone (940) 206-2747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260529002990 CA Practitioner - Registered Dietitian Or Nutrition Professional 8628548724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

350 Parnassus Ave
San Francisco, CA 94117-3649

PO Box
Phoenix, AZ 85072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD004422GAMDRegistered Dietitian

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1184158016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2576 KENWOOD DR",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963636",
            "telephone_number": "940-206-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 MCCLURE BRIDGE RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963223",
            "telephone_number": "678-312-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "FLAVIA",
        "credential": "R.D.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD004422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; 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.