Susan Boger-Wakeman, PHD, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L002487 Issued in NC

Practice address

150 Prices CRK
Saluda, NC 28773-6758

Phone

(828) 329-6976

NPI assigned

Sep 11, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Susan Boger Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1447409669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PRICES CRK",
            "city": "SALUDA",
            "state": "NC",
            "postal_code": "287736758",
            "telephone_number": "828-329-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PRICES CRK",
            "city": "SALUDA",
            "state": "NC",
            "postal_code": "287736758",
            "telephone_number": "828-329-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGER-WAKEMAN",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PHD, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L002487",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "134",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BOGER",
            "prefix": "DR.",
            "credential": "PHD, RD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clifford Lloyd Clark Jr., C.O.T.A/L
• Melinda Tapia Clark, COTA/L
• Theresa Davis, FNP

• Registered Dietitian in Saluda, NC
• Providers in Saluda, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; 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.