Active NPI
Susan Anne Zikos, MBA, RD, LDN, CDCES
- Registered Dietitian
- Wexford, PA
National Provider Identifier
1407453210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN004511
- Practice address
- 229 Edelweiss Dr
Wexford, PA 15090-9454 - Phone
- (412) 302-9825
- NPI assigned
- Oct 5, 2020
- 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 | DN004511 | PA | Primary |
Addresses
Primary practice location
229 Edelweiss Dr
Wexford, PA 15090-9454
Mailing address
229 Edelweiss Dr
Wexford, PA 15090-9454
Phone (412) 302-9825
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 Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN004511 | PA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1407453210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 EDELWEISS DR",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150909454",
"telephone_number": "412-302-9825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 EDELWEISS DR",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150909454",
"telephone_number": "412-302-9825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIKOS",
"first_name": "SUSAN",
"middle_name": "ANNE",
"credential": "MBA, RD, LDN, CDCES",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-05",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN004511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wexford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.