Susan Dade, RD
Individual provider Active NPI Registered Dietitian · Artesia, NM
NPI 1356306237 · NPPES record last updated Jun 21, 2021
Key facts
- NPI
- 1356306237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 103 (NM)
- Practice address
- 606 N 13TH St Ste 300
Artesia, NM 88210-1133 - Phone
- (575) 736-8233
- NPI assigned
- Apr 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041006000352 | NM | Practitioner - Registered Dietitian Or Nutrition Professional | 4880653898 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103 | NM | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Artesia General Hospital | Current |
Accepting new patients | |
| Artesia General Hospital | Current |
Accepting new patients | |
| Artesia General Hospital | Past | Accepting new patients | |
| Pecos Valley of New Mexico, LLC | Past | Accepting new patients |
Locations
702 N 13th St
Artesia, NM 88210
Phone (505) 748-3333
606 N 13th St
Ste 300
Artesia, NM 88210
Phone (575) 736-8233
612 N 13th St
Ste G
Artesia, NM 88210
Phone (505) 736-8262
712 N 13TH St
Artesia, NM 88210
Phone (575) 748-8000
712 N 13TH St
Artesia, NM 88210
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/artesia-6a02e1ef
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 103 | NM | Yes |
Addresses
Primary practice location
606 N 13TH St Ste 300
Artesia, NM 88210-1133
Mailing address
702 N 13TH St
Artesia, NM 88210-1199
Phone (575) 748-3333
Other practice location 1
617 W Pierce St
Carlsbad, NM 88220-5240
Phone (505) 887-8183
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | multispecialty@artesiageneral.hin.us | Direct |
Other providers in Artesia, NM
- Xan Creighton
- Laurie Danielle Crockett
- Patricia A Crook
- Rachel Crutcher
- Rosanna M D'Amico
- Samantha Davis
- Day Six Integrative Wellness, LLC
- Kit Dilley
- Camille Ann Doan
- Emily Dominguez
All providers in Artesia, NM · Registered Dietitian in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.