Individual provider Active NPI

Julie Suckow, R.D.

  • Registered Dietitian
  • Wenatchee, WA
National Provider Identifier
1396010666
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI61514909 Issued in WA
Practice address
1737 N Wenatchee Ave Ste E
Wenatchee, WA 98801-1189
Phone
(702) 569-7782
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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 DI61514909 WA Primary

Addresses

Primary practice location

1737 N Wenatchee Ave Ste E
Wenatchee, WA 98801-1189

Mailing address

1710 Country Club Dr
E Wenatchee, WA 98802-4231
Phone (702) 569-7782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120501000761 NV Practitioner - Registered Dietitian Or Nutrition Professional 6103088521 Reassigns benefits to 1 organization
I20240417003571 WA Practitioner - Registered Dietitian Or Nutrition Professional 6103088521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1737 N Wenatchee Ave
Suite E
Wenatchee, WA 98801-1189
Phone (509) 645-2079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI61514909WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
509 Nutrition & Diabetes Care, PLLC Dietitian, Registered CurrentSince Mar 28, 2024 Accepting new patients
Mullen Family Chiropractic PLLC CurrentSince Feb 25, 2024 Accepting new patients
Nutrition by Joey, LLC Dietitian, Registered PastSince Jan 14, 2012 Accepting new patients

Locations

1737 N Wenatchee Ave
Ste E
Wenatchee, WA 98801
Phone (509) 645-2079

Organizations & group practices 4

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": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1396010666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 COUNTRY CLUB DR",
            "city": "E WENATCHEE",
            "state": "WA",
            "postal_code": "988024231",
            "telephone_number": "702-569-7782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 N WENATCHEE AVE STE E",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011189",
            "telephone_number": "702-569-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCKOW",
        "first_name": "JULIE",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI61514909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.