Individual provider Active NPI

Susan B Moyers, PHD. MPH. LDN.

  • Nutrition Education Nutritionist
  • Tampa, FL
National Provider Identifier
1528286655
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
License
ND3395 Issued in FL
Practice address
4522 W Village Dr
Suite 129
Tampa, FL 33624-3429
Phone
(813) 948-9040
Fax
(813) 482-0014
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X ND3395 FL Primary
Registered Dietitian 133V00000X ND3395 FL
Metabolic Nutrition Registered Dietitian 133VN1006X ND3395 FL
Research Study Specialist 1744R1102X

Addresses

Primary practice location

4522 W Village Dr
Suite 129
Tampa, FL 33624-3429

Mailing address

4522 W Village Dr
Suite 129
Tampa, FL 33624-3429
Phone (813) 948-9040

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

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1528286655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 W VILLAGE DR",
            "address_2": "SUITE 129",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336243429",
            "telephone_number": "813-948-9040",
            "fax_number": "813-482-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4522 W VILLAGE DR",
            "address_2": "SUITE 129",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336243429",
            "telephone_number": "813-948-9040",
            "fax_number": "813-482-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYERS",
        "first_name": "SUSAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PHD.  MPH. LDN.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "FL",
            "license": "ND3395",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND3395",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "FL",
            "license": "ND3395",
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.