Active NPI
Susanne Mackinnon, RD
- Registered Dietitian
- Duluth, GA
National Provider Identifier
1992305486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD005695
- Practice address
- 2678 Hummingbird Dr NW
Duluth, GA 30096-3998 - Phone
- (770) 232-2616
- NPI assigned
- Oct 26, 2020
- 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 | LD005695 | GA | Primary |
Addresses
Primary practice location
2678 Hummingbird Dr NW
Duluth, GA 30096-3998
Mailing address
2678 Hummingbird Dr NW
Duluth, GA 30096-3998
Phone (770) 232-2616
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 |
|---|---|---|---|
| LD005695 | GA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1992305486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2678 HUMMINGBIRD DR NW",
"city": "DULUTH",
"state": "GA",
"postal_code": "300963998",
"telephone_number": "770-232-2616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2678 HUMMINGBIRD DR NW",
"city": "DULUTH",
"state": "GA",
"postal_code": "300963998",
"telephone_number": "770-232-2616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKINNON",
"first_name": "SUSANNE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-26",
"last_updated": "2020-10-26",
"certification_date": "2020-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD005695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.