Susan L. Delagrange

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

910521 Issued in IN

Legal business name

SUSAN L. DELAGRANGE

Practice address

2607 Barry Knoll Way
Fort Wayne, IN 46845-1942

Phone

(260) 433-3367

Fax

(260) 637-5780

NPI assigned

Feb 9, 2010

Organization subpart

No

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

Authorized official

Name

Susan Lynn Delagrange, MS., RD.

Title

Registered Dietitian

Phone

(260) 433-3367

Specialties & licenses 1

Addresses

Other names 1

• Susan Delagrange Sole Mbr Other name

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268611200000",
    "number": "1619209152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 BARRY KNOLL WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451942",
            "telephone_number": "260-433-3367",
            "fax_number": "260-637-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 BARRY KNOLL WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451942",
            "telephone_number": "260-433-3367",
            "fax_number": "260-637-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN L. DELAGRANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-03-15",
        "status": "A",
        "authorized_official_last_name": "DELAGRANGE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "260-433-3367",
        "authorized_official_credential": "MS., RD."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "910521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susan Delagrange Sole Mbr",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Registered Dietitian in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Registered Dietitian in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.