Sarah Gehring Provence, MS, RD, LDN, CDCES

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D1643 Issued in MS

Practice address

2150 Dickens Place Dr
Southaven, MS 38672-7152

Phone

(901) 387-7314

NPI assigned

Jun 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Networks

• TX HMO
• TX HMO D-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1003476417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 DICKENS PLACE DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727152",
            "telephone_number": "901-387-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 DICKENS PLACE DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727152",
            "telephone_number": "901-387-7314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENCE",
        "first_name": "SARAH",
        "middle_name": "GEHRING",
        "credential": "MS, RD, LDN, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "D1643",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "TN",
            "license": "2733",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Trans Non Medical Transportation
• Prime Urgent Medical Clinic
• Priority Health and Consultant LLC
• Privy Health, LLC
• Progressive Physicians Practice
• Providence Health, PLLC
• Timothy Michael Pruitt, DNP
• Merissa Pryor
• Psycamore LLC
• Psycamore, LLC

• Registered Dietitian in Southaven, MS
• Providers in Southaven, MS by specialty
• Registered Dietitian in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.