Susan E Wilson, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

168756 Issued in KY

Practice address

411 E Chestnut St # 5B
Louisville, KY 40202-1713

Phone

(502) 588-2330

Fax

(502) 588-9513

NPI assigned

Jan 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1497292759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E CHESTNUT ST # 5B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021713",
            "telephone_number": "502-588-2330",
            "fax_number": "502-588-9513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 E Gray St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023900",
            "country_code": "US",
            "telephone_number": "502-558-2354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 E Gray St Ste 802",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023904",
            "country_code": "US",
            "telephone_number": "502-558-2330",
            "fax_number": "502-588-9513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "168756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swilson109120@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "411 E Chestnut St # 5B",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "411 E Chestnut St # 5B",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Wilson, MPM, LAT, ATC
• Samantha H Wilson, BCBA
• Shari Wilson
• Stephanie K Wilson, B.S.
• Susan Annette Wilson, M.ED
• Sydney Wilson, LCSW
• Sylena K Wilson
• Theodore Ernest Wilson, MD
• Trey Allen Wilson, COTA
• William Wilson, PHYSICIAN ASSISTANT

• Registered Dietitian in Louisville, KY
• Providers in Louisville, KY by specialty
• Registered Dietitian in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.