Active NPI
Sandi Smith Davis, R.D., L.D.
- Renal Nutrition Registered Dietitian
- Fayetteville, AR
National Provider Identifier
1053665646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- 131163
- Practice address
- 2388 N Yorkwood Dr
Fayetteville, AR 72703-4140 - Phone
- (479) 387-0603
- NPI assigned
- Nov 4, 2012
- 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 |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | 131163 | AR | Primary |
Addresses
Primary practice location
2388 N Yorkwood Dr
Fayetteville, AR 72703-4140
Mailing address
2388 N Yorkwood Dr
Fayetteville, AR 72703-4140
Phone (479) 387-0603
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 |
|---|---|---|---|
| 131163 | AR | MD | Renal Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352073600000",
"number": "1053665646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2388 N YORKWOOD DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034140",
"telephone_number": "479-387-0603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2388 N YORKWOOD DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034140",
"telephone_number": "479-387-0603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SANDI",
"middle_name": "SMITH",
"credential": "R.D., L.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-04",
"last_updated": "2012-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "AR",
"license": "131163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.