Suzanne Marie Clark, RDN, LD, CDCES

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

8161378 Issued in ID

Practice address

16692 N Investor Loop Apt 102
Nampa, ID 83687-5227

Phone

(208) 406-6042

NPI assigned

Sep 30, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1679391627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16692 N INVESTOR LOOP APT 102",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16692 N INVESTOR LOOP APT 102",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875227",
            "telephone_number": "208-406-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "credential": "RDN, LD, CDCES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "ID",
            "license": "8161378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Clappier, PHARMD
• Clark Counseling and Wellness
• Charles Clark III, MD
• Kate Clark, FNP
• Saraya Clark, LPC
• Pamela Joan Clausen
• Renee Clausen, LMT
• Paul J Clawson, DDS
• Jonna Clayton
• Clearwater Dental PLLC

• Metabolic Nutrition Registered Dietitian in Nampa, ID
• Providers in Nampa, ID by specialty
• Metabolic Nutrition Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.