Individual provider Active NPI

Susan Thiel, RD

  • Registered Dietitian
  • Bellevue, WA
National Provider Identifier
1407961113
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI00002012 Issued in WA
Practice address
14350 SE Eastgate Way
Bellevue, WA 98007-6458
Phone
(206) 205-8974
Fax
(206) 205-8969
NPI assigned
Aug 20, 2006
Last updated
Sep 25, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 83 AK
Registered Dietitian 133V00000X DI00002012 WA Primary

Addresses

Primary practice location

14350 SE Eastgate Way
Bellevue, WA 98007-6458

Mailing address

311 S Bellflower Rd
Bothell, WA 98012-6235
Phone (425) 672-7007

Other identifiers 1

IdentifierTypeStateIssuer
DT0083MedicaidAK

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

State licenses

LicenseStateTypeSpecialty
DI00002012WAMDRegistered Dietitian
83AKMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1407961113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S BELLFLOWER RD",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980126235",
            "telephone_number": "425-672-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14350 SE EASTGATE WAY",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980076458",
            "telephone_number": "206-205-8974",
            "fax_number": "206-205-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEL",
        "first_name": "SUSAN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AK",
            "license": "83",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00002012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DT0083",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.