Active NPI
Julie Lynn Henderson, R.D.
- Registered Dietitian
- Sierra Vista, AZ
National Provider Identifier
1013095967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 836625
- Practice address
- 300 El Camino Real
Sierra Vista, AZ 85635-2812 - Phone
- (520) 417-4994
- Fax
- (520) 417-4994
- NPI assigned
- Nov 1, 2006
- 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 | 836625 | AZ | Primary |
Addresses
Primary practice location
300 El Camino Real
Sierra Vista, AZ 85635-2812
Mailing address
300 El Camino Real
Sierra Vista, AZ 85635-2812
Phone (520) 417-4994
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 836625 | Other | AZ | CDR |
| 00836625 | Other | AZ | AMERICAN DIETETIC ASS. |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 836625 | AZ | MD | Registered Dietitian |
| 000536 | OR | MD | Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013095967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 EL CAMINO REAL",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856352812",
"telephone_number": "520-417-4994",
"fax_number": "520-417-4994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 EL CAMINO REAL",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856352812",
"telephone_number": "520-417-4994",
"fax_number": "520-417-4994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "JULIE",
"middle_name": "LYNN",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "836625",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDR",
"identifier": "836625",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN DIETETIC ASS.",
"identifier": "00836625",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sierra Vista, AZ
- Heart and Vascular Associates LLC
- Sheila Anne Heiple, RN, BSN, MA
- Amy Marie Heise, M.A. CCC-SLP
- Helping Ourselves Pursue Enrichment, Inc.
- Governor Henry Henderson III, DNP
- Tammy Renee Heredia, RN
- Patricia E Herrewig, LPC
- Latoya Marie Herring, MEDICAL NAILTECH MNT
- Christen Herrington, CNM
- John N Herrod, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.