Active NPI
Stephanie M O'Donnell, RD, LDN
- Registered Dietitian
- Providence, RI
National Provider Identifier
1013239607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDN00657
- Practice address
- 1000 Eddy St
Providence, RI 02905-4739 - Phone
- (401) 533-9100
- NPI assigned
- Feb 23, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LDN00657 | RI | Primary |
Addresses
Primary practice location
1000 Eddy St
Providence, RI 02905-4739
Mailing address
1000 Eddy St
Providence, RI 02905-4739
Phone (401) 595-0434
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100524000137 | RI | Practitioner - Registered Dietitian Or Nutrition Professional | 7517096993 | Practice locations: Warwick, RI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDN00657 | RI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nurturing Nutrition II, LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1013239607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029054739",
"telephone_number": "401-595-0434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029054739",
"telephone_number": "401-533-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'DONNELL",
"first_name": "STEPHANIE",
"middle_name": "M",
"credential": "RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-23",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "RI",
"license": "LDN00657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.