Sue L Roscoe, RD

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

Practice address

300 E Warwick Dr
Alma, MI 48801-1014

Phone

(989) 466-3330

Fax

(989) 463-2540

NPI assigned

Aug 6, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sue L Overholt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1992936025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 608",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488010608",
            "telephone_number": "989-466-3330",
            "fax_number": "989-463-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E WARWICK DR",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488011014",
            "telephone_number": "989-466-3330",
            "fax_number": "989-463-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSCOE",
        "first_name": "SUE",
        "middle_name": "L",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "364144",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUE",
            "last_name": "OVERHOLT",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Renal Nutrition Registered Dietitian in Alma, MI
• Providers in Alma, MI by specialty
• Renal Nutrition Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.