Active NPI
Sarah M Tee, MPH RD LRD
- Registered Dietitian
- Fargo, ND
National Provider Identifier
1053198259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1117
- Practice address
- 1630 1St Ave N Ste B
Fargo, ND 58102-4246 - Phone
- (630) 439-4775
- NPI assigned
- Sep 11, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.006411 | IL | |
| Registered Dietitian | 133V00000X | 1117 | ND | Primary |
Addresses
Primary practice location
1630 1St Ave N Ste B
Fargo, ND 58102-4246
Mailing address
4758 11TH St W
West Fargo, ND 58078-8397
Phone (630) 439-4775
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 |
|---|---|---|---|
| 164.006411 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | 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": "1694390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1053198259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4758 11TH ST W",
"city": "WEST FARGO",
"state": "ND",
"postal_code": "580788397",
"telephone_number": "630-439-4775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 1ST AVE N STE B",
"city": "FARGO",
"state": "ND",
"postal_code": "581024246",
"telephone_number": "630-439-4775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEE",
"first_name": "SARAH",
"middle_name": "M",
"credential": "MPH RD LRD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-11",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.006411",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ND",
"license": "1117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.