Active NPI
Suzanne M Davis, RD, LDN, CDE
- Registered Dietitian
- Nantucket, MA
National Provider Identifier
1497966899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 659
- Practice address
- 57 Prospect St
Nantucket, MA 02554-2799 - Phone
- (508) 825-8141
- Fax
- (508) 825-8101
- NPI assigned
- May 25, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 659 | MA | Primary |
Addresses
Primary practice location
57 Prospect St
Nantucket, MA 02554-2799
Mailing address
57 Prospect St
Nantucket, MA 02554-2799
Phone (508) 825-8141
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 659 | Other | MA | LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 659 | MA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497966899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 PROSPECT ST",
"city": "NANTUCKET",
"state": "MA",
"postal_code": "025542799",
"telephone_number": "508-825-8141",
"fax_number": "508-825-8101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 PROSPECT ST",
"city": "NANTUCKET",
"state": "MA",
"postal_code": "025542799",
"telephone_number": "508-825-8141",
"fax_number": "508-825-8101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SUZANNE",
"middle_name": "M",
"credential": "RD, LDN, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "659",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "659",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nantucket, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.