Active NPI
Carolyn Suzanne Mueller, MS, RDN, LD, CDE
- Registered Dietitian
- Brookhaven, GA
National Provider Identifier
1336521855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD003677
- Practice address
- 3242 Cates Ave NE
Brookhaven, GA 30319-2308 - Phone
- (270) 991-4244
- Fax
- (678) 973-2984
- NPI assigned
- Jun 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD003677 | GA | Primary |
Addresses
Primary practice location
3242 Cates Ave NE
Brookhaven, GA 30319-2308
Mailing address
3242 Cates Ave NE
Brookhaven, GA 30319-2308
Phone (270) 991-4244
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD003677 | GA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434758400000",
"number": "1336521855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3242 CATES AVE NE",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303192308",
"telephone_number": "270-991-4244",
"fax_number": "678-973-2984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3242 CATES AVE NE",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303192308",
"telephone_number": "270-991-4244",
"fax_number": "678-973-2984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUELLER",
"first_name": "CAROLYN",
"middle_name": "SUZANNE",
"credential": "MS, RDN, LD, CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-20",
"last_updated": "2015-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD003677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookhaven, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.