Active NPI
Bethany Motes Suddreth, MS, RD, LD
- Registered Dietitian
- Greenville, SC
National Provider Identifier
1639542665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1685
- Practice address
- 1350 Cleveland St
Greenville, SC 29607-2440 - Phone
- (864) 675-3488
- Fax
- (864) 627-9131
- NPI assigned
- Nov 13, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD004464 | GA | |
| Registered Dietitian | 133V00000X | 1685 | SC | Primary |
Addresses
Primary practice location
1350 Cleveland St
Greenville, SC 29607-2440
Mailing address
1 Independence PT Ste 212
Greenville, SC 29615-4536
Other practice location 1
1350 Walton Way
University Hospital Outpatient Nutrition Services
Augusta, GA 30901-2612
Phone (706) 288-3079
Other names 1
- Bethany Michelle Motes
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD004464 | GA | MD | Registered Dietitian |
| 1685 | SC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1639542665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 INDEPENDENCE PT STE 212",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 CLEVELAND ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296072440",
"telephone_number": "864-675-3488",
"fax_number": "864-627-9131"
}
],
"practiceLocations": [
{
"address_1": "1350 Walton Way",
"address_2": "University Hospital Outpatient Nutrition Services",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309012612",
"country_code": "US",
"telephone_number": "706-288-3079",
"fax_number": "706-774-2152",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUDDRETH",
"first_name": "BETHANY",
"middle_name": "MOTES",
"credential": "MS, RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-13",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD004464",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "1685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BETHANY",
"last_name": "MOTES",
"middle_name": "MICHELLE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.