Active NPI
Susan Kay Cornett, R.D. L.D.
- Registered Dietitian
- Ft Worth, TX
National Provider Identifier
1720183601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT02735
- Practice address
- 300 W Rosedale St
Ft Worth, TX 76104-4856 - Phone
- (817) 882-6045
- Fax
- (817) 882-6595
- NPI assigned
- Sep 14, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT02735 | TX | Primary |
Addresses
Primary practice location
300 W Rosedale St
Ft Worth, TX 76104-4856
Mailing address
1414 New Haven Dr
Mansfield, TX 76063-3373
Phone (817) 473-2170
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
| License | State | Type | Specialty |
|---|---|---|---|
| DT02735 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720183601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 NEW HAVEN DR",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760633373",
"telephone_number": "817-473-2170",
"fax_number": "817-882-6595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W ROSEDALE ST",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761044856",
"telephone_number": "817-882-6045",
"fax_number": "817-882-6595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNETT",
"first_name": "SUSAN",
"middle_name": "KAY",
"credential": "R.D. L.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT02735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.