Susan Clark, MS, RD, LD, CDE
NPI 1124676663 · Registered Dietitian · Rexburg, ID
Enrolled with Medicare as Practitioner - Registered Dietitian Or Nutrition Professional · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Susan Clark, MS, RD, LD, CDE is a Registered Dietitian provider in Rexburg, ID (NPI 1124676663).
Provider details
- NPI number
- 1124676663
- Entity type
- Individual
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Credential
- MS, RD, LD, CDE
- Sex
- Female
- Sole proprietor
- No
- License
- D-393 (ID)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 450 E Main StRexburg, ID 83440-2048Phone: (208) 359-6522
Registry dates
- Enumerated
- 2019-08-28
- Last updated
- 2025-11-24
- Certified
- 2025-11-24
Frequently asked questions
- What is Susan Clark's NPI number?
- Susan Clark's National Provider Identifier (NPI) is 1124676663, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Susan Clark's specialty?
- Susan Clark is listed in the NPPES registry with a primary specialty of Registered Dietitian (Dietary & Nutritional Service Providers).
- Where is Susan Clark located?
- Susan Clark's practice location on file with NPPES is 393 E 2nd N, Rexburg, ID 83440-1605.
- What is Susan Clark's phone number?
- The practice phone number listed in the NPPES registry for Susan Clark is (208) 356-5401.
- Does Susan Clark accept Medicare?
- Susan Clark is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Susan Clark's NPI active?
- Yes — Susan Clark's NPI (1124676663) is active in the NPPES registry as of the last update on 2025-11-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.