Individual provider Active NPI

Susan Lee Morvich, RD LD BS BA

  • Registered Dietitian
  • Marion, IL
National Provider Identifier
1932274263
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
2401 W Main Street RM 113 Nhcu
Veterans Administration Medical Center
Marion, IL 62959
Phone
(618) 997-5311
Fax
(618) 998-5671
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

2401 W Main Street RM 113 Nhcu
Veterans Administration Medical Center
Marion, IL 62959

Mailing address

12327 Rend City Road
Benton, IL 62812
Phone (618) 927-5079

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
Credentials
Bachelor of Arts, Bachelor of Science

State licenses

LicenseStateTypeSpecialty
164000905ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932274263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12327 REND CITY ROAD",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "62812",
            "telephone_number": "618-927-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W MAIN STREET RM 113 NHCU",
            "address_2": "VETERANS ADMINISTRATION MEDICAL CENTER",
            "city": "MARION",
            "state": "IL",
            "postal_code": "62959",
            "telephone_number": "618-997-5311",
            "fax_number": "618-998-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORVICH",
        "first_name": "SUSAN",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "RD LD BS BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

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.

Verify at the official NPI Registry.