MS. SUSAN MARY RUNYAN (NPI# 1760442297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760442297 |
| Entity Type | Individual |
| Full Name | MS. SUSAN MARY RUNYAN |
| Credential | REGISTERED DIETITIAN |
| Practice Address |
354th Medical Group 2630 Central Ave, Suite 1m07 Eielson Afb AK 99702 |
| Mailing Address |
2594 Carrie Lynn Dr North Pole AK 99705-5639 |
| Practice Telephone | 9073776662 |
| Practice Fax Number | 9073771629 |
| Mailing Telephone | 9074882968 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 110 | AK | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568426641 | Susan J. Runyan | Family Medicine | 2410 California St, San Francisco, CA 94115-2681 | 2006-04-14 |
| Street Address |
354TH MEDICAL GROUP 2630 CENTRAL AVE, SUITE 1M07 |
| City | EIELSON AFB |
| State | AK |
| Zip Code | 99702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174864904 | Eric Noll | Optometrist | 2630 Central Ave # 3349, Eielson Afb, AK 99702 | 2013-03-04 |
| 1407125123 | Optical Center | Technician/Technologist | 451 Broadway Street, Eielson Afb Aafes Exchange, Eielson, AK 99702 | 2011-12-27 |
| 1063649234 | John Michael Strothenke | Military Health Care Provider | 2630 Central Avenue Suite 1, 354 Medical Operations Squadron, Clinical Medicine Flt, Eielson Air Force Base, AK 99702 | 2009-06-16 |
| 1225272073 | Landru Derek Medvec | Military Health Care Provider | 2422 Arctic Ave, Apt D, Eielson Afb, AK 99702 | 2009-04-23 |
| 1780875617 | Victoria L Ketchum | Specialist | E. Cowles, Fairbanks Memorial Hospital, Fairbanks, AK 99702 | 2007-08-06 |
| 1689768103 | Angie M. Walker | Social Worker | 2630 Central Av, Suite 1m07, Eielson Afb, AK 99702 | 2006-10-02 |
| 1306945464 | 354th Medical Group Mdg | Military/U.S. Coast Guard Pharmacy | Bldg 3349 Central Ave, Eielson Afb, AK 99702 | 2006-09-22 |
| 1972166916 | Andrew Joseph Colburn | Registered Nurse | 2630 Central Ave # 3349, Eielson Afb, AK 99702 | 2019-04-16 |
| 1952885121 | Anthony Ewell-kollmann | Dentist | 2630 Central Ave, Eielson Afb, AK 99702 | 2018-09-24 |
| 1306375704 | Robert Marshall Walter | Dentist | 2630 Central Ave Bldg 3349, Eielson Afb, AK 99702 | 2017-06-08 |
| Find all providers in zip 99702 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124631759 | Britta Amber Brecheen | Dietitian, Registered | 3403 Lois Dr, Anchorage, AK 99517-2000 | 2020-08-24 |
| 1518579473 | Soleil Thiele | Dietitian, Registered | 2210 N Broadway Dr, Palmer, AK 99645-9316 | 2020-08-20 |
| 1619593449 | Audrey Conrad | Dietitian, Registered | 16924 Foothill Ave Apt 3, Eagle River, AK 99577-8298 | 2020-06-17 |
| 1952934895 | Lea Palmer | Dietitian, Registered | 22835 Glacier View Dr, Eagle River, AK 99577-9560 | 2020-02-19 |
| 1457919227 | Janne Holmberg Maier | Dietitian, Registered | 250 Cushman St Ste 3h, Fairbanks, AK 99701-4665 | 2019-06-05 |
| 1326506866 | Balance and Nourish | Dietitian, Registered | 25 Jefferson Way Ste 101b, Ketchikan, AK 99901-5953 | 2019-03-04 |
| 1396217261 | Angela Marie Colburn | Dietitian, Registered | 2751 Debarr Rd Ste 250, Anchorage, AK 99508-6818 | 2018-12-17 |
| 1730658493 | Emily Nicole Henry | Dietitian, Registered | 97 Eichner Ave, Ketchikan, AK 99901-9033 | 2018-11-24 |
| 1063997096 | Sabrina Kay Cabana | Dietitian, Registered | 7900 Evander Dr, Anchorage, AK 99518-3107 | 2018-09-25 |
| 1700381134 | Kimberly Leinani Wilcox | Dietitian, Registered | 621 W Dimond Blvd, Anchorage, AK 99515-1704 | 2018-03-27 |
| Find all providers with the same taxonomy | ||||
| City | EIELSON AFB |
| Zip Code | 99702 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.