Individual provider Active NPI

Susan Wolfe

  • Nutritionist
  • Jamaica Plain, MA
National Provider Identifier
1518260348
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
137 Issued in MA
Practice address
3297 Washington St
Jamaica Plain, MA 02130-2655
Phone
(617) 971-2100
NPI assigned
Dec 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 137 MA Primary

Addresses

Primary practice location

3297 Washington St
Jamaica Plain, MA 02130-2655

Mailing address

3297 Washington St
Jamaica Plain, MA 02130-2655

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
137MAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1518260348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3297 WASHINGTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3297 WASHINGTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302655",
            "telephone_number": "617-971-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-16",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MA",
            "license": "137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.