Individual provider Active NPI

Susan Kay Raatz, RD

  • Metabolic Nutrition Registered Dietitian
  • Saint Paul, MN
National Provider Identifier
1609334739
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
1747 Issued in MN
Practice address
1539 Grand Ave
Saint Paul, MN 55105-2229
Phone
(833) 833-2590
NPI assigned
Mar 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 1747 MN Primary

Addresses

Primary practice location

1539 Grand Ave
Saint Paul, MN 55105-2229

Mailing address

806 Linwood Ave Apt 4
Saint Paul, MN 55105-3399
Phone (612) 385-2567

Other identifiers 1

IdentifierTypeStateIssuer
1747OtherMNBOARD OF DIETETICS AND NUTRITION PRACTICE

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
1747MNMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1609334739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 LINWOOD AVE APT 4",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053399",
            "telephone_number": "612-385-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052229",
            "telephone_number": "833-833-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAATZ",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "MN",
            "license": "1747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF DIETETICS AND NUTRITION PRACTICE",
            "identifier": "1747",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.