NPIMap

Organization Active NPI

Superior Sustenance, LLC

  • Registered Dietitian
  • Mesa, AZ
National Provider Identifier
1255680286
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
990773 Issued in AZ
Legal business name
SUPERIOR SUSTENANCE, LLC
Practice address
1745 S Alma School Rd
Ste 105
Mesa, AZ 85210-3009
Phone
(480) 577-7046
NPI assigned
Sep 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Authorized official

Name
Christine Wheeler, MS, RD
Title
Owner
Phone
(480) 577-7046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 990773 AZ Primary

Addresses

Primary practice location

1745 S Alma School Rd
Ste 105
Mesa, AZ 85210-3009

Mailing address

1745 S Alma School Rd
Ste 105
Mesa, AZ 85210-3009
Phone (480) 577-7046

Other names 1

  • Superior Sustenance Doing business as

National Provider Directory

National Provider Directory

Locations

1745 S Alma School Rd
Ste 105
Mesa, AZ 85210
Phone (480) 577-7046

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1255680286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 S ALMA SCHOOL RD",
            "address_2": "STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103009",
            "telephone_number": "480-577-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 S ALMA SCHOOL RD",
            "address_2": "STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103009",
            "telephone_number": "480-577-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR SUSTENANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-577-7046",
        "authorized_official_credential": "MS, RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "990773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Sustenance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.