Individual provider Active NPI

Bethany Motes Suddreth, MS, RD, LD

  • Registered Dietitian
  • Greenville, SC
National Provider Identifier
1639542665
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1685 Issued in SC
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

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

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

LicenseStateTypeSpecialty
LD004464GAMDRegistered Dietitian
1685SCMDOptometrist

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.

Verify at the official NPI Registry.