Susan Sullivan Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

SUSAN SULLIVAN NUTRITION LLC

Practice address

257 Avensong Dr
Lexington, SC 29072-7928

Phone

(803) 603-1700

NPI assigned

Jul 13, 2022

Last updated

Jul 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan Sullivan, RDN, LDNPI 1881184349

Title

Owner, Registered Dietitian

Phone

(803) 603-1700

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Bowles Sullivan, RDN, LD

  • Registered Dietitian
  • Lexington, SC
  • NPI 1881184349

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1235863424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 AVENSONG DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727928",
            "telephone_number": "803-603-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 AVENSONG DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727928",
            "telephone_number": "803-603-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN SULLIVAN NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER, REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "803-603-1700",
        "authorized_official_credential": "RDN, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Lexington, SC
• Providers in Lexington, SC by specialty
• Registered Dietitian in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.