Active NPI
Tanya Renee Lunsford, RD
- Registered Dietitian
- Fort Walton Beach, FL
National Provider Identifier
1013173707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 836192
- Practice address
- 115 Miracle Strip Pkwy SE Unit 204
Fort Walton Beach, FL 32548-6018 - Phone
- (850) 374-7604
- NPI assigned
- Aug 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND14079 | FL | |
| Registered Dietitian | 133V00000X | 836192 | IN | Primary |
| Registered Dietitian | 133V00000X | 3700100A | IN |
Addresses
Primary practice location
115 Miracle Strip Pkwy SE Unit 204
Fort Walton Beach, FL 32548-6018
Mailing address
1559 Ingle Rd Ste a
Defuniak Springs, FL 32433-5065
Phone (812) 592-4061
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 |
|---|---|---|---|
| ND14079 | FL | MD | Registered Dietitian |
| 3700100A | IN | MD | Registered Dietitian |
| 836192 | IN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jenco Medical and Mobility Inc | Past | Accepting new patients | |
| Emerald Coast Diabetes & Nutrition Center | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Physician
- Fort Walton Beach, FL
- NPI 1700307550
Dietitian, Registered
-
- Durable Medical Equipment & Medical Supplies
- North Vernon, IN
- NPI 1568570893
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778112000000",
"number": "1013173707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1559 INGLE RD STE A",
"city": "DEFUNIAK SPRINGS",
"state": "FL",
"postal_code": "324335065",
"telephone_number": "812-592-4061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 MIRACLE STRIP PKWY SE UNIT 204",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325486018",
"telephone_number": "850-374-7604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNSFORD",
"first_name": "TANYA",
"middle_name": "RENEE",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-01",
"last_updated": "2026-05-07",
"certification_date": "2026-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND14079",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "836192",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "3700100A",
"primary": false
}
],
"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 May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.