Active NPI
Deanna Ruth Anderson
- Registered Dietitian
- Fort Walton Beach, FL
National Provider Identifier
1003566944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND9720
- Practice address
- 1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708 - Phone
- (850) 862-1111
- NPI assigned
- Mar 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND9720 | FL | Primary |
Addresses
Primary practice location
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Mailing address
1016 Valparaiso Blvd
Niceville, FL 32578-3500
Phone (225) 276-8226
Other practice location 1
1016 Valparaiso Blvd
Niceville, FL 32578-3500
Phone (225) 276-8226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND9720 | FL | MD | Registered Dietitian |
Networks
- TX HMO D-SNP
- TX HMO
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648080000000",
"number": "1003566944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 VALPARAISO BLVD",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325783500",
"telephone_number": "225-276-8226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MAR WALT DR",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325476708",
"telephone_number": "850-862-1111"
}
],
"practiceLocations": [
{
"address_1": "1016 Valparaiso Blvd",
"address_purpose": "LOCATION",
"city": "Niceville",
"state": "FL",
"postal_code": "325783500",
"country_code": "US",
"telephone_number": "225-276-8226",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "DEANNA",
"middle_name": "RUTH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-24",
"last_updated": "2022-03-24",
"certification_date": "2022-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND9720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.