Dana Maria Herazo, RD,LD,CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

667852 Issued in AL

Practice address

251 N Bayou St
Mobile, AL 36603-5827

Phone

(251) 690-8847

Fax

(251) 544-2188

NPI assigned

Mar 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Dana Maria Suszkiw Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mobile County Board of Health

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
  • NPI 1659584555
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1962530840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 N BAYOU ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366035827",
            "telephone_number": "251-690-8847",
            "fax_number": "251-544-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 N BAYOU ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366035827",
            "telephone_number": "251-690-8847",
            "fax_number": "251-544-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERAZO",
        "first_name": "DANA",
        "middle_name": "MARIA",
        "credential": "RD,LD,CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD 131",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AL",
            "license": "667852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP PAYEE NUMBER",
            "identifier": "1063439065",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PAYEE NUMBER",
            "identifier": "011846",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000013",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "SUSZKIW",
            "middle_name": "MARIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Denise Henshaw
• Pamela Henshon
• John Milligan Hensley
• Matthew Henson
• William Randal Duncan Henson, DO
• Andrea N. Herbert, PT
• Heritage Dental Group USA.LLC
• Heritage Pharmacy, Inc.
• Heritage Woods Operations, LLC
• Gina Hermon

• Registered Dietitian in Mobile, AL
• Providers in Mobile, AL by specialty
• Registered Dietitian in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.