Active NPI
Mallory Crutchfield, MS, RD/LD
- Registered Dietitian
- Tulsa, OK
National Provider Identifier
1043751241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1821319278
- Practice address
- 8801 S 101St East Ave
Tulsa, OK 74133-5716 - Phone
- (918) 294-4070
- NPI assigned
- Mar 20, 2017
- Last updated
- Mar 20, 2017
- 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 | 1821319278 | OK | Primary |
Addresses
Primary practice location
8801 S 101St East Ave
Tulsa, OK 74133-5716
Mailing address
8735 E 46TH PL
Tulsa, OK 74145-7101
Phone (918) 728-1535
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1821319278 | OK | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489968000000",
"number": "1043751241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8735 E 46TH PL",
"city": "TULSA",
"state": "OK",
"postal_code": "741457101",
"telephone_number": "918-728-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8801 S 101ST EAST AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741335716",
"telephone_number": "918-294-4070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUTCHFIELD",
"first_name": "MALLORY",
"credential": "MS, RD/LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-20",
"last_updated": "2017-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1821319278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.