Zella Pavlov, MA, RDN/LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2204 Issued in OK

Practice address

783 Grand Casino Blvd
Shawnee, OK 74804

Phone

(405) 214-5117

NPI assigned

Mar 23, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Zella Classen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1033812730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 SHORESIDE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731702536",
            "telephone_number": "580-227-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "783 GRAND CASINO BLVD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "74804",
            "telephone_number": "405-214-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLOV",
        "first_name": "ZELLA",
        "credential": "MA, RDN/LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "2204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZELLA",
            "last_name": "CLASSEN",
            "credential": "MA, RDN/LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.