Cynthia Brantly, RD
Individual provider Active NPI Registered Dietitian · Monroe, LA
NPI 1003346883 · NPPES record last updated Jun 11, 2019
Key facts
- NPI
- 1003346883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1158 (LA)
- Practice address
- 1325 Louisville Ave
Monroe, LA 71201-6021 - Phone
- (318) 807-1500
- Fax
- (318) 807-1504
- NPI assigned
- Jun 14, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Baton Rouge Clinic, a Medical Corporation
Practice addresses (Care Compare)
7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 246-9790
920 Oliver Rd
Monroe, LA 71201-5702
Phone (318) 998-3426
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.51 of 100
- Quality
- 60.04
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170628000688 | LA | Practitioner - Registered Dietitian Or Nutrition Professional | 1557630944 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1158 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baton Rouge Clinic, a Medical Corporation | Current |
Accepting new patients | |
| Baton Rouge Clinic, a Medical Corporation | Current |
Accepting new patients | |
| Affinity Health Group, LLC | Dietitian, Registered | Current |
Accepting new patients |
| Affinity Health Group, LLC | Current |
Accepting new patients |
Locations
7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790
1325 Louisville Ave
Monroe, LA 71201
Phone (318) 807-1500
130 Desiard St
Ste 355
Monroe, LA 71201
Phone (318) 807-7875
920 Oliver Rd
Monroe, LA 71201
Phone (318) 807-6267
2408 Broadmoor Blvd
Ste 2
Monroe, LA 71201
Phone (318) 807-0525
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1158 | LA | Yes |
Addresses
Primary practice location
1325 Louisville Ave
Monroe, LA 71201-6021
Mailing address
130 Desiard St Ste 355
Monroe, LA 71201-7363
Phone (318) 807-7875
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2452304 | Medicaid | LA |
Other providers in Monroe, LA
- Mary Branch
- Madelyn Bryan Brandl
- Tracy Brandly
- Jennifer Brandt
- Tanya Brandy
- Hanna Elise Brashier
- Ortadius Brass
- Robin Brass
- James Peyton Braswell
- Roy Braswell
All providers in Monroe, LA · Registered Dietitian in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.