Individual provider Active NPI

Susan Kay Young, RD, CSO

  • Oncology Nutrition Registered Dietitian
  • Durango, CO
National Provider Identifier
1700196631
Registry record updated Feb 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Nutrition Registered DietitianTaxonomy code 133VN1301X
License
1024929 Issued in CO
Practice address
2257 Main Ave
Durango, CO 81301-4660
Phone
(970) 946-0620
Fax
(970) 422-1076
NPI assigned
Oct 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2021

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 1024929 CO
Oncology Nutrition Registered Dietitian 133VN1301X 1024929 CO Primary

Addresses

Primary practice location

2257 Main Ave
Durango, CO 81301-4660

Mailing address

2257 Main Ave Unit a
Durango, CO 81301-4659
Phone (970) 946-0620

Other practice location 1

1 Mercado St
Suite 100
Durango, CO 81301-7306
Phone (970) 385-7977 ext. 125

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1024929COMDOncology Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612656000000",
    "number": "1700196631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 MAIN AVE UNIT A",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014659",
            "telephone_number": "970-946-0620",
            "fax_number": "970-422-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2257 MAIN AVE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014660",
            "telephone_number": "970-946-0620",
            "fax_number": "970-422-1076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Mercado St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813017306",
            "country_code": "US",
            "telephone_number": "970-385-7977 x125",
            "fax_number": "970-385-6727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "credential": "RD, CSO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-13",
        "last_updated": "2021-02-07",
        "certification_date": "2021-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": "1024929",
            "primary": false
        },
        {
            "code": "133VN1301X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": "CO",
            "license": "1024929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2021; 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.