Susan Marie Wiseman, R.D., L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

4435 Issued in OH

Practice address

200 Saint Clair Ave
Saint Marys, OH 45885-2400

Phone

(419) 394-3335

NPI assigned

May 19, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Marie Gerdemann Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Joint Township District Memorial Hospital

  • General Acute Care Hospital
  • Saint Marys, OH
  • NPI 1639133002
  NPD
• JTDM Family Practice LLC

  • Family Medicine Physician
  • St Marys, OH
  • NPI 1184652539
  NPD (past)

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1699094433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-394-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-394-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "R.D., L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-19",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "4435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "GERDEMANN",
            "middle_name": "MARIE",
            "credential": "R.D.,L.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Wilson, SLP
• Nicholas D Wilson, PT
• Clarinda Yvette Wine
• Douglas J Wine, OD
• Jalyn Yvette Wine, STNA
• Wishing Well Clinic & Spa, LLC
• Jessica Jean Wuebker, APRN-CNP
• Thomas Joseph Zegarski, MD
• Katherine T. Zwiebel, CNP

• Registered Dietitian in Saint Marys, OH
• Providers in Saint Marys, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.