Individual provider Active NPI

Susan Yesavage, MA RD LDN CDE

  • Registered Dietitian
  • Baltimore, MD
National Provider Identifier
1811156946
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D01131 Issued in MD
Practice address
4940 Eastern Ave
Johns Hopkins Bayview Medical Center
Baltimore, MD 21224-2735
Phone
(410) 550-4431
Fax
(410) 550-0650
NPI assigned
Jun 4, 2008
Last updated
Jun 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D01131 MD Primary

Addresses

Primary practice location

4940 Eastern Ave
Johns Hopkins Bayview Medical Center
Baltimore, MD 21224-2735

Mailing address

4940 Eastern Ave
Johns Hopkins Bayview Medical Center
Baltimore, MD 21224-2735
Phone (410) 550-4431

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
D01131MDMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1811156946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "address_2": "JOHNS HOPKINS BAYVIEW MEDICAL CENTER",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-4431",
            "fax_number": "410-550-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "address_2": "JOHNS HOPKINS BAYVIEW MEDICAL CENTER",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-4431",
            "fax_number": "410-550-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YESAVAGE",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "MA RD LDN CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "D01131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.