Emina Suta, MS RD RDN INFCP

Key facts

NPI

1770224040

Entity type

Individual (NPI type 1)

Primary specialty

Registered Dietitian 133V00000X

License

1067549 (VA)

Practice address

22959 Fanshaw SQ
Brambleton, VA 20148-5673

Phone

(614) 806-7550

NPI assigned

Apr 2, 2022

Sex

Female

Sole proprietor

Yes

Organizations & group practices 1

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.

• Julie Starkel Nutrition LLC Registered Dietitian · Seattle, WA · NPI 1780064683
  NPD (past) DIETITIAN, REGISTERED

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 15, 2024 through Jun 15, 2028

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

Other names

• Emina Hadzic Other name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 2, 2022.

{
    "created_epoch": "1648857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648857600000",
    "number": "1770224040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22959 FANSHAW SQ",
            "city": "BRAMBLETON",
            "state": "VA",
            "postal_code": "201485673",
            "telephone_number": "614-806-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22959 FANSHAW SQ",
            "city": "BRAMBLETON",
            "state": "VA",
            "postal_code": "201485673",
            "telephone_number": "614-806-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTA",
        "first_name": "EMINA",
        "name_prefix": "Mrs.",
        "credential": "MS RD RDN INFCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-02",
        "last_updated": "2022-04-02",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "1067549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCES",
            "identifier": "0000",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCES",
            "identifier": "000000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMINA",
            "last_name": "HADZIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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