Active NPI
Eric James Siebenmorgen, RDN
- Registered Dietitian
- Paris, AR
National Provider Identifier
1023789013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86253454
- Practice address
- 2908 W Walnut St
Paris, AR 72855-3017 - Phone
- (479) 518-2069
- NPI assigned
- Sep 21, 2021
- Last updated
- Nov 20, 2024
- Sex
- Male
- 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 | 86253454 | AR | Primary |
Addresses
Primary practice location
2908 W Walnut St
Paris, AR 72855-3017
Mailing address
2908 W Walnut St
Paris, AR 72855-3017
Phone (479) 518-2069
Other practice location 1
2908 W Walnut St
Paris, AR 72855-3017
Phone (479) 518-2069
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 |
|---|---|---|---|
| 86253454 | AR | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732060800000",
"number": "1023789013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2908 W WALNUT ST",
"city": "PARIS",
"state": "AR",
"postal_code": "728553017",
"telephone_number": "479-518-2069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2908 W WALNUT ST",
"city": "PARIS",
"state": "AR",
"postal_code": "728553017",
"telephone_number": "479-518-2069"
}
],
"practiceLocations": [
{
"address_1": "2908 W Walnut St",
"address_purpose": "LOCATION",
"city": "Paris",
"state": "AR",
"postal_code": "728553017",
"country_code": "US",
"telephone_number": "479-518-2069",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIEBENMORGEN",
"first_name": "ERIC",
"middle_name": "JAMES",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-21",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AR",
"license": "86253454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paris, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.