Individual provider Active NPI

Julisu Dimucci-Ward, PHD, RD,CDE,LD

  • Registered Dietitian
  • Spartanburg, SC
National Provider Identifier
1487795670
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
721719 Issued in SC
Practice address
350 Howard St
Spartanburg, SC 29303-3515
Phone
(864) 327-9907
Fax
(864) 804-6986
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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
Registered Dietitian 133V00000X 721719 SC Primary

Addresses

Primary practice location

350 Howard St
Spartanburg, SC 29303-3515

Mailing address

350 Howard St
Spartanburg, SC 29303-3515
Phone (864) 327-9907

Other identifiers 1

IdentifierTypeStateIssuer
DT1016MedicaidSC

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
721719SCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center PastSince Aug 13, 2012 Accepting new patients

Organizations & group practices 1

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1487795670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 HOWARD ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033515",
            "telephone_number": "864-327-9907",
            "fax_number": "864-804-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HOWARD ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033515",
            "telephone_number": "864-327-9907",
            "fax_number": "864-804-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMUCCI-WARD",
        "first_name": "JULISU",
        "name_prefix": "Dr.",
        "credential": "PHD, RD,CDE,LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "721719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DT1016",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.

Verify at the official NPI Registry.